If Mothers Only Knew

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In an opinion piece published in the June issue of the American Journal of Obstetrics and Gynecology, Dr. Dwight J. Rouse from the Center of Women’s Reproductive Health at the University of Alabama at Birmingham, suggests that a thousand fewer children each year would suffer from handicapping cerebral palsy if magnesium sulfate were uniformly administered to mothers prior to delivery of children born prematurely at 32 weeks gestation or sooner.

Indeed, a debate has been ongoing about the use of magnesium sulfate to lower the risk of cerebral palsy for many years.  Between 2003 and 2008 three large studies of magnesium sulfate used to protect the infant brain were reported.  Individually and collectively the results of the studies justify the administration of magnesium sulfate to pregnant women threatening delivery prior to 32 weeks to protect their babies who survive their preterm birth from developing cerebral palsy.

In spite of the published studies and the opinion piece by Dr. Rouse and others, magnesium sulfate remains, “unproven” and its use is not the standard of practice for preventing cerebral palsy though it is regularly used by obstetricians for the treatment of other conditions.

Where are the voices of mothers and mothers to be in this debate.  For those who know the hardships faced by children with cerebral palsy and their families, the lack of action by leaders in obstetrics to bring about a change is inexplicable but not uncommon.

Many children died needlessly from neonatal respiratory distress syndrome during the 22 year period between the first individual trial which demonstrated in 1972 that steroids given to the mother prior to birth would be effective in preventing the syndrome until 1994 when the National Institutes of Health consensus guidelines were published making the administration of steroids prior to early preterm birth standard.

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