Quote from SC RN
I have a patient on L&D (antepartum) who has been on complete bedrest for PTL for 30 days now. The doses of Magnesium Sulfate that we have to give her to stay out of labor are so large that she is constantly sick and miserable and she is now ready to give up. She feels that she just can't stay pregnant any longer or she'll lose her mind (hx of depression, first child at 29 wks - now healthy). An ultrasound first showed the AFI of Baby A to be 3 so she was going to be having a c/sec but a subsequent u/s showed the AFI to be 7.4 so she is in a waiting game yet again.
She is now 31 4/7 wks pregnant with twins. I have searched all over the internet looking for something to give her that states a day by day benefit of keeping them in their longer. Does anyone now of such a thing? I'd love to be able to visually show her the benefits to the lungs, the GI tract, the Brain, etc, etc. I'm hoping you wise NICU nurses can help me ... I really want to help her "want" to stay pregnant ... altho I can't say that I know how miserable it is to be on MGSo4 for this long of a time! Thanks for your help!
Boy, do I feel for that woman! I had 2 high risk pregnancies with very resistant pre-term labor. Every time I was admitted, I required a loading dose of 6-8 grams of MgSO4, followed by 4-6 grams per hour for at least 48 hours. By the third or fourth admission, I was ready to give up due to feeling so miserably sick myself, but as a NICU nurse, I knew the harm that could cause my still very premature babies. I had a long discussion with my primary nurse and physician regarding what measures could be taken to lessen the ill effects of the Mag therapy, and how to make my admission(s) more tolerable so that I would be willing to continue with the only medication that was effective in bringing my contractions under control.
We agreed to a private room, consistent group of nurses, sedation and anti-nausea medications, limited monitoring, less frequent vitals, reflex checks and blood draws (once a stable level had been achieved) so that I could actually get some rest, family to provide appetizing food from home, etc.
While nothing can possibly make Mag therapy pleasant, these things went a long way toward making it bearable. Perhaps you could approach your patient and her OB/CNM with some of these suggestions.
Please give her my best, from someone who has been there, and now has 2 healthy girls to show for it!