الفهرس 
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Abstract
Preterm birth remains the principle cause of early neonatal death. Infants born preterm which is defined as labour before 37 weeks of gestation often suffer significant immediate morbidity and need lengthy stay in neonatal intensive care units with significant risk of long term neurological morbidity in a proportion of the survivors. The earlier the preterm labour the more the risk especially when labour occurs before 32 weeks.
Aim of the work:Aim of the work is to assess the effect of Mgso4 before and after its administration as a tocolytic agent on Doppler ultrasound parameters of fetal middle cerebral arteries (MCA) ,umbilical artery (UA) and uterine artery(UtA) in pregnant woman with threatened preterm labour.
Results: , there is a non-statistically significant reduction in RI ,PI,SD Ratio of the UA before 32 weeks gestation while a statistically significant reduction in these parameters after 32 weeks gestation following magnesium sulphate infusion.
Regarding MCA doppler parameters in this study, there is a statistically significant reduction in RI,PI ,SD ratio after magnesium sulphate infusion.
Regarding UtA Doppler parameters in this study ,There are No statistically significant differences were found in uterine artery RI and S/D ratio following magnesium sulphate infusion; whereas uterine artery PI showed statistically significant reduction after magnesium sulphate infusion.
Conclusion: although the use of Mgso4 as a tocolytic agnet is controversial but it is valuable as neuroprotective agent and for treatment of eclamptic seizures . Its effect on the fetal blood flow has a very beneficial role till now. In this study it was found that it has significant effect on fetal MCA, UA and UtA Doppler parameters (RI,PI and S/D ratio).
Recommendations: It’s recommended to perform further studies to assess the effect of Magnesium sulphate on further doppler parameters . The next studies should be performed on larger number of patients, a control group with matched age and comorbidities will give more reliable statistical results.
Another recommendation is to conduct a larger scale study with multicenter design, this will involve more personnel which reduce the biaz possibilities, but on the cost of inter-observer accuracy.
Another recommendation is to detect the effect of another tocolytic agents (atosiban ,ritodrine,....,etc ) on doppler parameters in women with preterm labour.
Assessment of fetal anterior cerebral artery Doppler indices as well as Middle cerebral artery indices may give more information about the fetal cerebral blood flow before and after MgSo4 administration in the upcoming studies.
There is inter-observer variability in the results of ultrasound based assessment, so its recommended to keep the same ultrasound operator all through the study to avoid these mild changes and that is we didn’t do in our study