Intoxicación neonatal por sulfato de magnesio: Caso clínico

Abstract

Magnesium Sulfate is currently the treatment of choice for severe preeclampsia and eclampsia. Since it crosses the placenta, magnesium can reach high levels in fetal plasma, ocassionally reaching levels higher than maternal plasma. Objective: To analyze a 35 weeks gestational age newborn, who presented hypermagnesemia due to maternal treatment with magnesium sulfate (in routine dosage) indicated for severe preeclampsia. Clinical Case: The mother was infused with MgSO4 for 17 hours until pregnancy was interrupted because of fetal monitoring. The baby weighed 2,620 grams, was depressed, hypotonic, cyanotic and without respiratory effort and only partially responded to initial resucitation with positive pressure ventilation. The infant was admitted to the Neonatal Intensive Care Unit for monitoring, support and management. High levels of plasma MgSO4 were found (4.7 mg/dl), compatible with the diagnosis of hypermagnesemia. Symptoms and signs slowly disappeared, and the child was discharged after 10 days of hospitalization. Conclusion: We present the clinical case of a newborn with a history of maternal use of magnesium sulfate, who presented hypermagnesemia characterized by neonatal depression, hypotonia, central apnea with oxygen requirement and who progressively normalized in a 10 day period.