Neonatal Hypermagnesemia: Report of One Case

新生兒高鎂血症：一病例報告

滕儒錚(Ru-Jeng Teng) ； 劉曉峻(Hsiao-Chun Liu) ； 鄒國英(Kuo-Inn Tsou Yau)

《Acta Paediatrica Sinica》 30卷5期 (1989/10) Pp. 333-336

摘要

硫酸鎂(MgSO4•7H2O)是一種廣泛被用於控制妊娠毒血症的藥物，其安全性早已被證實對母體及胎兒均不易造成傷害；雖然如此，依然有病例報告在子癇前症的母親使用硫酸鎂的靜脈或肌肉注射後產出呼吸窘迫、低肌肉張力、低反射的新生兒，由於這些新生兒的臍血或靜脈血中的鎂離子濃度較正常新生兒為高，故稱之為“新生兒高鎂血症”。
作者於今年遭遇一相同病例，患嬰為早產女嬰，其母親於產前曾接受靜脈硫酸鎂之注射達五十公克。此女嬰初生時之Apgar score為2及6分，隨後出現呼吸停止及肌肉張力消失，臍血中鎂濃度高達4.56毫當量／公升（正常值0.9至2.6毫當量／公升），經呼吸器支持十二小時及靜脈施予葡萄糖酸鈣200毫克，患嬰完全恢復。追蹤檢查亦未見神經學之異常。
雖然硫酸鎂之使用對孕婦及胎兒均極安全，我們仍應對這些新生兒做仔細的追踪，若血中鎂離子濃度超過2.4毫當量1公升，同時有症狀出現時，便應該施予支持性治療。

並列摘要

A female baby was born prematurely to a pre-eclampsic mother at our hospital. The mother had received fifty grams of magnesium sulfate intravenously within the forty-six hours prior to the delivery. This neonate sufferedfrom severe respiratory distress, hypotonia, and hyporeflexia immediately after birth. She recovered completely after receiving low setting ventilatory support for twelve hours and intravenous calcium gluconate supply. All laboratory data were within normal limits except transient metabolic acidosis and elevated serum magnesium level to 2.28 mmol/L of the cord blood. The serum magnesium level dropped to 1.17 mmol/L at 12 hours of age. She tolerated oralfeeding within the first day with no obervable neurological sequelae at the follow-up examination. Hypermagnesemia was judged to be the cause of the newborn's clinical presentation.

並列關鍵字

neonatal hypermagnesemia ； pre-eclampsia ； magnesium sulfate ； respiratory distress