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Randomized trials have demonstrated that administering magnesium sulfate before anticipated very preterm birth reduces the risk of cerebral palsy and substantial gross motor dysfunction in surviving children. For maternal-fetal medicine teams, the practical issue is recognizing when delivery is sufficiently imminent to justify treatment and administering it early enough to provide benefit. This indication is distinct from magnesium sulfate for seizure prophylaxis in preeclampsia, and protocols should clearly separate the two. The evidence supports incorporating fetal neuroprotection into standardized preterm-delivery pathways, particularly in tertiary centers where transfer and neonatal care can be coordinated.
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Randomized trials have demonstrated that administering magnesium sulfate before anticipated very preterm birth reduces the risk of cerebral palsy and substantial gross motor dysfunction in surviving children. For maternal-fetal medicine teams, the practical issue is recognizing when delivery is sufficiently imminent to justify treatment and administering it early enough to provide benefit. This indication is distinct from magnesium sulfate for seizure prophylaxis in preeclampsia, and protocols should clearly separate the two. The evidence supports incorporating fetal neuroprotection into standardized preterm-delivery pathways, particularly in tertiary centers where transfer and neonatal care can be coordinated.
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