Is there benefit to continue magnesium sulphate postpartum in women receiving magnesium sulphate before delivery? A randomised controlled study.

OBJECTIVE: To determine if the use of magnesium sulphate postdelivery reduces the risk of eclampsia in women with severe pre-eclampsia exposed to at least 8 hours of magnesium sulphate before delivery. DESIGN: Randomised multicentre controlled trial. SETTING: Latin America. POPULATION: Women with severe pre-eclampsia that had received a 4-g loading dose followed by 1 g per hour for 8 hours as maintenance dose before delivery. METHODS: In all, 1113 women were randomised; 555 women were randomised to continue the infusion of magnesium sulphate for 24 hours postpartum and 558 were randomised to stopping the magnesium sulphate infusion immediately after delivery. OUTCOME MEASURES: Primary outcome was the incidence of eclampsia in the first 24 hours postdelivery. Secondary outcomes included maternal death, maternal complications, time to start ambulation and time to start lactation. RESULTS: The maternal characteristics at randomisation between the groups were not different. There were no differences in the rate of eclampsia; 1/555 (0.18%) versus 2/558 (0.35%) [relative risk (RR 0.7, 95% CI 0.1-3.3; P = 0.50] or maternal complications between the groups (RR 1.0, 95% CI 0.8-1.2; P = 0.76). Time to start ambulation was significantly shorter in the no magnesium sulphate group (18.1 ± 10.6 versus 11.8 ± 10.8 hours; P = 0.0001) and time to start lactation was equally shorter in the no magnesium sulphate group (24.1 ± 17.1 versus 17.1 ± 16.8 hours; P = 0.0001). CONCLUSIONS: Women with severe pre-eclampsia treated with a minimum of 8 hours of magnesium sulphate before delivery do not benefit from continuing the magnesium sulphate for 24 hours postpartum. TWEETABLE ABSTRACT: No benefit of continuing magnesium sulphate postpartum in severe pre-eclampsia exposed to this drug for a minimum of 8 hours before delivery.

Phosphorus in seagull colonies and the effect on the habitats. The case of yellow-legged gulls (Larus michahellis) in the Atlantic Islands National Park (Galicia-NW Spain).

During the period 1980-2000, the yellow-legged gull population underwent exponential growth due to an increase in the availability of anthropogenic food resources. The aim of this study was to highlight the effect of the gull colonies on the P soil cycle and the associated effects on coastal ecosystems. Samples of soil, water and faecal material were collected in a colony of yellow-legged gulls (Cíes Islands) and in a control area. Four sampling plots were installed in the study areas, and samples were collected in summer and winter in 1997 and 2011. Sample analysis included soil characterization and determination of the total P content (TP), bioavailable-P and fractionated-P forms in the soils and faecal material. The (31)P NMR technique was also used to determine organic P forms. Clear differences between the gull colony soils and the control soil were observed. The TP was 3 times higher in the gull colony soil, and the bioavailable P was 30 times higher than in the control soil. The P forms present at highest concentrations in the faecal material (P-apatite, P-residual and P-humic acid) were also present at high concentrations in the colony soil. The absence of any seasonal or annual differences in P concentration indicates that the P has remained stable in the soil over time, regardless of the changes in the gull population density. The degree of P saturation indicated that soils are saturated with P due to the low concentration of Fe/Al-hydroxides, which is consistent with a high P concentration in the run-off from the colonies. The P output from the colony soils to coastal waters may cause eutrophication of a nearby lagoon and the disappearance of a Zostera marina seagrass meadow. Similarly, the enrichment of P concentration in dune system of Muxieiro may induce irreversible changes in the plant communities.