Effect of magnesium sulfate on blood coagulation status in pregnant women with preeclampsia

Document Type : Original Article

Authors

1 Professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

2 Professor, Department of Social Medicine, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

3 Assistant professor, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

4 Intern, Department of Obstetrics and Gynecology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Introduction: According to some studies, magnesium in pharmacological concentrations has antithrombotic effects, causing platelet dysfunction in vitro and in vivo. This study was performed with aim to evaluate the effect of magnesium sulfate on blood coagulation status in pregnant women with preeclampsia.
Methods: This cross-sectional study was performed in 2013-2014 on 56 pregnant women with mild preeclampsia. Platelet count and magnesium levels, bleeding time (BT), prothrombin time (PT), and activated partial thromboplastin time (aPTT) were measured before and two hours after magnesium sulfate injection. Data were collected and analyze by SPSS software (version 16) and paired t-test and Chi-square test. P<0.05 was considered statistically significant.
 Results: Mean serum magnesium level in the patients was 4.53 ± 0.51 mEq/L. Mean platelet count of patients before and after prescribing magnesium were 176.55±43.84 ×1000 vs 173.25±51.51×1000, respectively; no significant difference was observed (P=0.108). Mean PT (prothrombin time) before and after the treatment was 13.36 ± 0.69 seconds vs 13.57± 0.79 seconds, respectively. There was no significant difference between PT before and after treatment (P = 0.059). Mean PTT (partial thromboplastin time) before and after the treatment was 38.1± 2.05 and 38.26± 2.92 seconds, respectively. There was no significant difference between PTT before and after treatment (P=0.756). Mean BT of women before and after magnesium administration were 109.55±39.7 vs 123.48±44.87, respectively (P=0.013).
Conclusion: BT in therapeutic values increased in pregnant women after prescribing magnesium sulfate.

Keywords

References

  1. Farzaneh F, Tavakolikia Z, Soleimanzadeh Mousavi SH. Assessment of occurrence of preeclampsia and some clinical and demographic risk factors in Zahedan city in 2017. Clinical and Experimental Hypertension 2019; 41(6):583-8.
  2. Lambert G, Brichant JF, Hartstein G, Bonhomme V, Dewandre PY. Preeclampsia: an update. Acta Anaesthesiol Belg 2014; 65(4):137-49.
  3. Dekker GA. Management of preeclampsia. Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health 2014; 4(3):246-7.
  4. Kashanian M, Koohpayehzadeh J, Sheikhansari N, Bararpour F, Sahraian G, Asadolla S. A comparison between the two methods of magnesium sulfate administration for duration of 12 versus 24 h after delivery in patients with severe preeclampsia. J Matern Fetal Neonatal Med 2016; 29(14):2282-7.
  5. Héman L, Linden P. Does magnesium sulfate increase the incidence of postpartum hemorrhage? A systematic review. Open Journal of Obstetrics and Gynecology 2011; 1(4):168-73.
  6. James MF. Magnesium in obstetrics. Best Pract Res Clin Obstet Gynaecol 2010; 24(3):327-37.
  7. Fuentes A, Rojas A, Porter KB, Saviello G, O'Brien WF. The effect of magnesium sulfate on bleeding time in pregnancy. Am J Obstet Gynecol 1995; 173(4):1246-9.
  8. Leaphart WL, Meyer MC, Capeless EL, Tracy PS. Adenosine diphosphate-induced platelet activation inhibited by magnesium in a dose-dependent manner. Obstetrics & Gynecology 1998; 91(3):421-5.
  9. Gries A, Bode C, Gross S, Peter K, Böhrer H, Martin E. The effect of intravenously administered magnesium on platelet function in patients after cardiac surgery. Anesth Analg 1999; 88(6):1213-9.
  10. Mannuß S, Schuff-Werner P, Dreißiger K, Kohlschein P. Magnesium Sulfate as an Alternative In Vitro Anticoagulant for the Measurement of Platelet Parameters? Am J Clin Pathol 2016; 145(6):806-14.
  11. Schuff-Werner P, Steiner M, Fenger S, Gross HJ, Bierlich A, Dreissiger K, et al. Effective estimation of correct platelet counts in pseudothrombocytopenia using an alternative anticoagulant based on magnesium salt. Br J Haematol 2013; 162(5):684-92.
  12. Meledeo MA, Campbell JE, Rodriguez AC, Valenciana MV, Cap AP. Both acute delivery of and storage with magnesium sulfate promote cold-stored platelet aggregation and coagulation function. J Trauma Acute Care Surg 2015; 79(4 Suppl 2):S139-45.
  13. Dong JF, Cruz MA, Aboulfatova K, Martin C, Choi H, Bergeron AL, et al. Magnesium maintains endothelial integrity, up-regulates proteolysis of ultra-large von Willebrand factor, and reduces platelet aggregation under flow conditions. Thromb Haemost 2008; 99(3):586-93.
  14. Harrison P. Platelet function testing. UpToDate 2019. Available at: https://www.uptodate.com/contents/platelet-function-testing
  15. Gawaz M, Ott I, Reininger AJ, Neumann FJ. Effects of magnesium on platelet aggregation and adhesion. Magnesium modulates surface expression of glycoproteins on platelets in vitro and ex vivo. Thromb Haemost 1994; 72(6):912-8.
  16. Ravn HB, Vissinger H, Kristensen SD, Husted SE. Magnesium inhibits platelet activity--an in vitro study. Thromb Haemost 1996; 76(1):88-93.
  17. Falck G, Lundgaard H, Jareld T, Skarra S, Arbo I, Gunnes S, et al. Effect of magnesium infusion on bleeding time in healthy male volunteers. Scand J Clin Lab Invest 1999; 59(6):425-30.
  18. Kynczl-Leisure M, Cibils LA. Increased bleeding time after magnesium sulfate infusion. American journal of obstetrics and gynecology 1996; 175(5):1293-4.
  19. Assaley J, Baron JM, Cibils LA. Effects of magnesium sulfate infusion upon clotting parameters in patients with pre-eclampsia. J Perinat Med 1998; 26(2):115-9.
  20. Guzin K, Goynumer G, Gokdagli F, Turkgeldi E, Gunduz G, Kayabasoglu F. The effect of magnesium sulfate treatment on blood biochemistry and bleeding time in patients with severe preeclampsia. The Journal of Maternal-Fetal & Neonatal Medicine 2010; 23(5):399-402.
  21. Choccalingam C, Radha RKN, Snigdha N. Estimation of Platelet Counts and Other Hematological Parameters in Pseudothrombocytopenia Using Alternative Anticoagulant: Magnesium Sulfate. Clin Med Insights Blood Disord 2017; 10:1179545X17705380.
  22. Mannuß S, Kohlschein P, Dreißiger K, Schuff-Werner P. Measurement of Platelet Counts and Volume Using Magnesium Sulfate as an Anticoagulant:  Comparison of Impedance and Light-Scatter Technology. Am J Clin Pathol 2016; 146(5):538-545.
  23. Ravn HB, Vissinger H, Kristensen SD, Wennmalm A, Thygesen K, Husted SE. Magnesium inhibits platelet activity--an infusion study in healthy volunteers. Thromb Haemost 1996; 75(6):939-44.
  24. Shechter M, Merz CN, Paul-Labrador M, Meisel SR, Rude RK, Molloy MD, et al. Beneficial antithrombotic effects of the association of pharmacological oral magnesium therapy with aspirin in coronary heart disease patients. Magnes Res 2000; 13(4):275-84.
  25. Graham NM, Gimovsky AC, Roman A, Berghella V. Blood loss at cesarean delivery in women on magnesium sulfate for preeclampsia. J Matern Fetal Neonatal Med 2016; 29(11):1817-21.
  26. Rafieian-Kopaie M, Nasri H. Platelet counts and mean platelet volume in association with serum magnesium in maintenance hemodialysis patients. J Renal Inj Prev 2012; 1(1):17-21.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 23, Issue 12
February 2021
Pages 1-5

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