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A randomized controlled trial of magnesium sulfate for the prevention of cerebral palsy is a 2008 study published in the New England journal of medicine. The study is authored by Dwight Ropuse, Deborah Hirtz, Elizabeth Thom, Michael Varner and others. The research was aimed at investigating whether an exposure of a fetus to magnesium sulfate prior to preterm birth has the capability of reducing the threat of cerebral palsy. Cerebral palsy is distinguished by unusual regulation of posture and movement that leads to restraint of activity. It occurs due to nonprogressive injury or dysfunction of an infant’s brain or developing fetus and is a primary source of infancy disability, with intense economic, medical, and emotional outcomes. This study was performed to investigate the proposition that the administration of the magnesium sulfate to pregnant females who are at an increased risk of delivering before their term would lessen the hazard of cerebral palsy in children (Dwight et al, 2008).

The random control trial was performed at twenty participating women. Women were qualified if they were bearing twins or singletons at twenty fourth through thirty first weeks of  their gestation, and were at a great threat for unprompted delivery due to the rapture of membranes taking place at the 22nd week throughout 31st week, or gestation, or due to complex  preterm labor having dilatation of four to eight centimeters and intact membranes. Dwight et al (2008) argue that women were also qualified if a proved preterm delivery was anticipated within two to twenty four hours because of fetal development restriction. Women were not qualified if delivery was expected within fewer than two hours. Additional exclusion criterion entailed rapture of membranes prior to 22 weeks of gestation, unwillingness of obstetrician to get involved for the gain of fetus, fetal anomalies or death, preeclampsia or maternal hypertension, presence of intense pulmonary disorders in mothers.

In this random control trial, the authors indiscriminately assigned females at imminent hazard for delivery amid twenty four and thirty one weeks of gestation to get magnesium sulfate, which was intravenously administered as a six gram bolus followed by a consistent mixture of two grams hourly or corresponding placebo. If delivery had not taken place after twelve hours and was thus not regarded imminent, the infusion was withdrawn and recommenced, the delivery was considered imminent again. If six hours had passed after discontinuation of research medication, another loading dosage was administered. Retreatment was held back in eclampsia or preeclampsia occurred, whereby magnesium sulfate was given for seizure prophylaxis (Dwight et al, 2008).

The principal result was the combination of infant death at the age of one year or still birth or severe to moderate cerebral palsy as evaluated two-year-old infants. The occurrence of death of infants before they were one year old was also included since it is a competing result that would disqualify the evaluation of cerebral palsy. The authors regarded the possibility of making a diagnosis of the disease at one year, even though their objective was to make the diagnosis based on two year examination. The infants with a normal neurological test at one year could walk ten steps without any support and possessed bilateral pincer clasp, did not have cerebral palsy and were thus considered normal. Dwight et al (2008) note that, from these results, it can be concluded that the exposure of fetus to magnesium sulfate prior to expected early preterm delivery did not lessen the composite threat of death or severe to moderate cerebral palsy, even though the occurrence of cerebral palsy was minimized among survivors. The study also established that treatment of women at imminent hazard for delivery amid twenty four and thirty weeks of gestation does not have considerable effect on principal composite result of death or severe to moderate cerebral palsy.

Code: Sample20

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