Periviable birth: management and counseling issues--volume 1.

Magnesium sulfate (MgSO4) has been shown to prevent cerebral palsy among children born to women at high risk of early preterm delivery. Three large, randomized placebo-controlled trials and a subsequent Cochrane Review suggest this intervention can decrease rates of cerebral palsy by 32% with a number needed to treat of 63 to prevent one case. Not only is MgSO4 familiar to obstetricians, it also has an excellent safety profile. Simple protocols exist to help guide clinicians in using MgSO4 for this indication. Evaluation of actual clinical practice shows that this use is both feasible and can be accomplished parsimoniously.