Fundus changes in pregnancy induced hypertension

AIM: To determine the prevalence of retinal changes in pregnancy induced hypertension (PIH) and any association between the retinal changes and blood pressure, proteinuria, and severity of the disease. METHODS: All the patients admitted with diagnosis of PIH were included in this study. Age, race, gravida, gestation period, blood pressure, and proteinuria were noted from the case records. After taking history for any eye symptoms, fundus examination was done after dilating the pupils with direct ophthalmoscope in the ward itself. All the findings were noted on a data sheet, and were analyzed using SPSS programme. RESULTS: A total of 78 patients of PIH were examined. Majority (75.6%) were Malays. The mean age of patients was 30.2 years (range 21-45 years). The gestation period ranged from 25 weeks to 41 weeks; 34 (43.5%) were primi gravida. Thirty (38.4%) patients had mild preeclampsia, 46 (59%) had severe preeclampsia and 2(2.5%) had eclampsia. Retinal changes (hypertensive retinopathy) were noted in 46 (59%) patients --- grade I in 41 (52.6%) and grade II in 5 (6.4%). Haemorrhages or exudates or retinal detachment were not seen in any patient. There was statistically significant positive association of retinal changes and blood pressure (P =0.001), proteinuria (P =0.018) and severity of the PIH (P =0.024). CONCLUSION: Retinal changes (grade I and II hypertensive retinopathy) were seen in 59% of patients with PIH and they were significantly associated with blood pressure, proteinuria and severity of the disease. Fundus examination helps in assessing the severity of PIH.

Change of hs-CRP,sVCAM-1,NT-proBNP levels in patients with pregnancy-induced hypertension after therapy with magnesium sulfate and nifudipine

Objective:To investigate the change of the hs-CRP,sVC AM-1,NT-proBNP levels of the patients with pregnancy-induced hypertension(PIH) syndrome.Methods:A total of 200 patients with PIH were divided into mild,moderate and severe group,and 50 healthy pregnancy patients served as the control group.The serum sVCAM-1 levels were detected by enzyme-linked immunosorbent assay,hs-CRP were detected by immunity transmission turbidity,and NT-proBNP levels were determined by the colloidal gold method.Patients were treated with magnesium sulfate and nifudipine and the contrastive analysis was performed before and after treatment.And the pathological changes in placental of PIH patients were delected by hematoxylin-eosin staining at the same time.Results:The hs-CRP,sVCAM-l,NT-proBNP levels of patients in the mild, moderate and severe PHI group were significantly higher than that in the control group(P<0.05). The hs-CKP,sVCAM-l,NT-proBNP levels in the severe group were significantly higher than the mild group and the moderate group,the difference was statistically significant(P<0.05).The hsCRP,sVCAM-l,NT-proBNP of the moderate group were significantly higher than the mild group(P<0.05).There was a positive correlation between hs-CRP,sVCAM-1,NT-proBNP expression levels and the degree of the PIH.The expression of hs-CRP,sVCAM-1,NT-proBNP levels of the moderate and the severe group were significantly decreased(P<0.05).The number of placental villi and interstitial blood vessel in the moderate and severe PIH group were significantly less than the control group(P<0.05).Conclusions:The increased levels of serum hs-CRP,sVCAM-1, NT-proBNP may be involved in the process of vascular endothelial cell injury of the PIH,and the hs-CRP,sVCAM-1,NT-proBNP can be used as the auxiliary index for diagnosis of PIH and determination of PIH severity.

Increased Oxidative Stress in Women With Pregnancy-induced Hypertension

Objective To investigate whether pregnancy-induced hypertension （PIH） may increase oxidative stress in women with PIH, and to explore the mechanisms by which PIH may increase oxidative stress and potential free radical damage. Methods Seventy women with PIH and seventy women with uncomplicated normotensive pregnancy （UNP） whose age, nutritional conditions, levels of hemoglobin and albumin were all matched, were enrolled in a randomized controlled trial. Their plasma concentrations of nitric oxide （NO）, vitamin C （VC）, vitamin E （VE）, and β-carotene （β-CAR） as well as their erythrocyte malondialdehyde （MDA）, and activities of superoxide dismutase （SOD）, catalase （CAT） and glutathione peroxidase （GPX） were determined by spcctrophotometry. Results Compared with average values of the above experimental parameters in the women with UNP, the average value of erythrocyte MDA in the women with PIH significantly increased （P〈0.0001）, while the average values of plasma NO, VC, VE, and β-CAR as well as those of erythrocyte SOD, CAT, and GPX in the women with PIH significantly decreased （P〈0.0005-0.0001）. The findings from partial correlation analysis （controlling for age） for 70 women with PIH showed that with elevated systolic blood pressure （SBP） and diastolic blood pressure （DBP）, MDA value gradually increased （P〈0.001）, and NO, VC, VE, β-CAR, SOD, CAT, and GPX values gradually decreased （P〈0.02-0.001）. The findings from reliability analysis for NO, VC, VE, β-CAR, SOD, CAT, GPX, and MDA values used to reflect increased oxidative stress and potential free radical damage in women with PIH showed that the reliability coefficients （alpha, 8 items） = 0.7062, P〈 0.0001, and the standardized item alpha = 0.9116, P〈 0.0001. Conclusion The findings in the present research suggest that pregnancy-induced hypertension can increase oxidative stress and potential free radical damage in women with pregnancy-induced hypertension.

Expression of TGF-β1 in Placenta of the Patients with Pregnancy-induced Hypertension and Its relationship with Serum VCAM-1

The expression of transforming growth factor-β1 (TGF-β1) in placental tissue of pregnancy-induced hypertension (PIH) and the relationship between the level of expression of TGF-β1 and the amount of vascular cell adhesion molecule-1 (VCAM-1) in serum was studied. Immunohistochemistry ABC was used to detect the expression and distribution of TGF-β1 in placental tissues in 40 PIH women and 20 normal pregnancy women. High resolution pathological image analysis system was used to determine the quality of TGF-β1. The VCAM-1 in serum was examined by enzyme linked immunoabsorbent assay (ELISA). The results showed that TGF-β1 could be express in syncytiotrophoblast. The levels of TGF-β1 expression in placental tissues of the patients with moderate and severe PIH were significantly higher (P<0.05), while the serum VCAM-1 was significantly lower than in normal group (P<0.01). There was a significant positive correlation between the expression of TGF-β1 in placental tissues and the serum VCAM-1 (r=0.969, P<0.01). It was concluded that the level of TGF-β1 expression in PIH was increased and was positively correlated with the amount of serum VCAM-1, indicating that they might be involved in the pathogenesis of PIH.

Expression of Endothelial Nitric Oxide Synthase Traffic Inducer in the Placenta of Pregnancy Induced Hypertension

The expression of endothelial nitric oxide synthase traffic inducer （NOSTRIN） in the placenta of the patients with pregnancy induced hypertension （PIH） was detected and its role in the pathogenesis of PIH was studied. The pathological changes in placental vessels were observed by HE staining. NO2-/NO3- , the stable metabolic end products of NO, was measured with nitrate reductase. The eNOS activity in placental tissues was assayed by spectrophotometry. Western blot analysis was applied to detect NOSTRIN expression. The incidence of thickening and fibronoid necrosis of placental vessels was significantly higher in women with PIH than in the normal group （P〈 0.01）. The levels of placental NO2-/NO3- in PIH patients （27. 53±7.48 μmol/mg） were significantly lower than in normal group （54. 27±9.53 μmol/mg, P〈0.01）. The activity of eNOS was significantly decreased in PIH group （12. 826±3.61 U/mg） as compared with that in normal group （21. 72±3.83 U/mg, P〈0.01）. Western blot analysis revealed that both groups expressed 58 kD NOSTRIN, but the protein level was significantly higher in women with PIH than in the normal group （P〈0.01）. A significant negative correlation existed between the expression of NOSTRIN protein and the activity of eNOS in placental tissue of women with PIH （r=-0.57, P〈0.01）. It was concluded that the level of NOSTRIN expression in placenta of women with PIH was increased, which may play an important role in the pathogenesis of PIH.

Changes of plasma nitric oxide in patients with pregnancy induced hypertension

Objective: To explore the role of nitric oxide (NO), an internal vasodilative factor, in occurrence ofpregnancy induced hypertension (PIH). Methods: The antepartum and postpartum levels of NO2-/NO3-, the stable metabolic end product of NO, and those of cyclic guanosine monophosphate (cGMP) in 30 patients with PIHand 30 healthy women in their late pregnancy were measured with greiss reagent. ResultS: ① The plasma levels ofNO2-/NO3- and cGMP were significantly decreased in patients with PIH as compared with the healthy women (P<0. 05). ②In patients with PlH, the antepartum level of NO2-/NO3- was markedly lower than the postpartum one(P<O. ol ). ③There was a negative correlation between the level of plasma NO2- /NO3- and systolic blood pressurein patients with PIH (P<0. 01). ④ A positive correlation was found between the level of plasma NO2-/NO3- andthat of cGMP in patients with PIH (P<0. 01). Conclusion: The decrease of NO synthesis may play an importantrole in occurrence of PIH.

Immunohistochemical Analysis of Globulin and Complements in Blood Vessels of Placental Villi during Pregnancy Induced Hypertension

The changes of globulin and complements in placental villi blood vessels were immunohistochemically studied in pregnancy induced hypertension patients and normal pregnant patients by a randomized , double-blind approach. The immunostaining of IgG, IgE, C3, C4, and 5-HT was seen in the villous blood vessels and the helicine arteries of pregnancy induced hypertensive placental villi.The strong positive rates were 100%, 90%, 100%, 100% and 90% in seriouspregnancy induced hypertensive patients, accompanied by aggregation of mastocytes and vasculopathy of villous blood vessels and the helicine arteries. It is concluded that the immuno-pathological damage took place in the villous blood vessels and helicine arteries, resulting in vasculopathy and villous regressive changesand that the immunological factors were closely related to pregnancy induced hypertension.

A Cross-Sectional Study on Current Practice of the Management of Pregnancy Induced Hypertension and Its Maternal and Foetal Complications and Outcome in the Western Part of the State of Libya

Background: Maternal and perinatal mortality and morbidity are mainly affected by hypertension during pregnancy (pre-eclampsia). Haemorrhage and cerebral bleeding are the primary and significant complications of pre-eclampsia. Abruption of the placenta and renal failure are among the major complications caused by this disease. The perinatal complications include Intrauterine Growth Restriction (IUGR), Intrauterine Foetal Death (IUFD), neonatal death, and prematurity. Objective: The purpose of the present study was to examine the incidence of Pregnancy-Induced Hypertension (PIH), pre-eclampsia, the management of PIH, including the early diagnosis, the pharmacological drug management used, and the prevalence of maternal and perinatal complications. Methods and Patients: This cross-sectional study took place in Aljalaa maternity hospital, which represented the west of the state of Libya in the period from 1st January 2012 to 31st December 2012, with patients who were diagnosed, managed, and terminated according to protocol management of the hospital. Results: In the present study, from the total deliveries in Aljalaa Maternity hospital, the incidence of PIH is 8.4% and pre-eclampsia is 5.1%. No maternal mortality, CNS haemorrhaged, hepatic failure, or renal failure. The reported maternal complications included: Eclampsia, HELLP syndrome (Haemolysis, Elevated Liver enzymes and Low platelets), abruption placenta, and pulmonary oedema see in eighteen percent, six percent, nine percent, four percent and less than one percent, respectively. The foetal complications were preterm babies and Intrauterine Growth Restriction (IUGR) in nineteen percent, Low Birth Weight (LBW) in twenty-five percent, Intrauterine Foetal Death (IUFD) in five percent, neonatal death in two percent and, perinatal death in six percent. In the PIH patients, the presence of associated symptoms such as headache, blurred vision, irritability, and the presence of signs such as severe hypertension, generalized oedema, exaggerated reflexes, and abnormal investigations (protein urea, high uric acid, abnormal LFT, haemoconcentration, and low pits) increased the risk of maternal and foetal complications. Conclusion: To decrease mother and newborn mortality and morbidity in PIH patients, a rigorous management protocol is required to implement evidence-based guidelines.

The decrease of serum vascular endothelial growth factor concentration in patients with pregnancy induced hypertension

Objectives:To detect the concentration of serum vascular endothelial growth factor (VEGF) in patients with pregnancy induced hypertension (PIH) as well as to explore the role of VEGF in the pathogenesis of Pffl.Methods: Serum VEGF concentrations in 23 healthy nonpregnant women (normal group) ,30 normal pregnant women (control group) and 37 women with PIH (PIH group) were measured by sandwich enzyme- linked immunoadsorbent assay (ELISA). Results: Serum concentrations of VEGF in control group were significantly higher (149.39 + 27.15ng/L) than those in normal group (11.98 + 3.99ng/L) ( P < 0.001) , peaking in the second trimester of pregnancy (183.84 + 49.02ng/L) and decreasing in the third trimester (118.37 + 34.29ng/L) . Serum VEGF concentrations (64.45 + 24.33ng/L) in PIH group were significantly lower than those in normal late pregnancy women of control group (118.37 + 34.29ng/L) ( P < 0.01) . There was a trend that serum VEGF concentrations in PIH group decreased with the severity of Pffl (P < 0.05) . Conclusion: The serum VEGF concentration in PIH women are significantly decreased, which suggests that VEGF may play an important role in the pathogenic mechanism of PIH.

The Expression of PLF in Placenta in Pregnancy-Induced Hypertension and the Relationship between the PLF and Serum VCAM-1

To study the expression of placental isoferritin (PLF) in placental tissue of pregnancy-induced hypertension (PIH) and the relationship between the level of expression of PLF and the amount of vascular cell adhesion molecule-1 (VCAM-1) in serum, immunohistochemical technique was used to detect the expression of PLF in placenta tissue in 45 PIH patients (PIH group) and 15 normal pregnant women (normal group). High resolution pathological image analysis system (HPIAS-100) was employed to determine the quantity of PLF. The VCAM-1 in serum was examined by enzyme linked immunoabsorbent assay (ELISA). The results showed that the levels of PLF expressions in moderate and severe PIH patients were significantly lower than that of normal group (P<0. 01). The serum VCAM-1 was significantly decreased in PIH group (1310±177 ρ/ng/ml) than that of normal group (609±72 ρ/ng/ml, P<0. 01). The significant negative correlation existed between the expression of PLF in placental tissue and the serum VACM-1 (r=-0. 58, P<0. 01). It was concluded that the level of PLF expression in PIH decreases and is negatively correlated with the amount of serum VCAM-1, indicating that these may be involved in the pathogenesis of PIH.

The Activity of Plasma Platelet-activating Factor Derived from Pregnant Women before and after Delivery and lts Relation to Pregnancy-induced Hypertension

The activity of plasma platelet-activating factor(PAF) from pregnant women before and after delivery was determined. Plasma samples were taken from 74 pregnant women, among whom 24 were normotensive controls, 30 mild and moderate hypertensive and 20 severe hypertensive. Of the two hypertensive groups(pregnancy-induced hypertension, PIH), PAF activity measured by a bioassay was significantly higher than that of normotensive control at 38 weeks in gestation , indicating a possible role of this potent lipid mediator in the pathophysiological mechanism of PIH. After delivery, PAF activity was obviously increased in all three groups , showing the regulation of placenta in PAF metabolism.

Effects of IGF-Ⅱand TGF-β1 on invasiveness of placental trophoblast cells in patients with pregnancy-induced hypertension syndrome

Objective: This study was to investigate the invasiveness of pregnancy-induced hypertension (PIH) trophoblast cells and evaluate the effects of IGF-Ⅱand TGF-β1 on cytotrophoblast invasion.Methods: Cytotrophoblast cells from normal and PIH placenta were separated and purified. Cytotrophoblast invasiveness of normal and PIH placenta was measured by in vitro invasion assay. Effects of IGF-Ⅱand TGF-β1 on cytotrophoblast invasion were also studied.Results: In PIH group, cytotrophoblast invasiveness was dramatically decreased. In normal group, trophoblast invasiveness was significantly enhanced by IGF-Ⅱ but inhibited by TGF-β1. Neither IGF-Ⅱ nor TGF-β1 had statistically significant effects on PIH trophoblast invasion.Conclusions: PIH cytotrophoblast invasiveness dramatically decreases as compared to the normal level. IGF-Ⅱand TGF-β1 may play an important role in shallow trophoblast invasion on PIH.

Study of the Prevalence of Hypertension and Complications of Hypertensive Disorders in Pregnancy

Introduction: Hypertension is one of the common problems associated with pregnancy that may be followed by eclampsia, acute renal failure, maternal death, premature delivery, intra-uterine growth restriction and other. This study was conducted to determine the results of pregnancies associated with hypertension in patients visiting in the Delivery Ward of Valiasr Hospital. Methods: A descriptive study was conducted on all the patients admitted to the aforementioned department and who possessed the inclusion criteria for hypertensive pregnancy. Results: Among the 1694 delivery cases examined, 173 cases had hypertension (9.8%). Among these, 75 (45%) had gesta-tional hypertension;24 (14.8%) had preeclampsia-eclampsia;30 (18%) had preeclampsia su-perimposed on chronic hypertension;21 (13.5%) cases had chronic hypertension;and 13 (8%) had pregnancy-aggravated chronic hypertension. Ninety-six point three percent (96.3%) had a systolic blood pressure (BP) of 140 - 190 mmHg, and 3.7% had a systolic BP greater than 190 mmHg. Whereas 61.1% of diastolic blood pressure 90 - 110 mmHg and 38.9% of the mothers had diastolic BP greater than 110 mmHg. The HELLP (Hemolysis, Elevated Liver enzymes & Low Platelet count) syndrome was present in 4.9% of cases;52.6% experienced premature delivery;7.4% had IUFD (intra uterine fetal death);9.9% had IUGR (intrauterine growth retardation);and 17.3% had LBW babies. Conclusions: Based on our results, hypertensive mothers who are younger and have lower weight babies at birth experience more perinatal complications. The unpleasant effects of hypertension in pregnancy warrant the need for training, routine prenatal care, the early detection and treatment of hypertension at younger ages of pregnancy, and follow-up after delivery.

超声定位下罗哌卡因与利多卡因椎管内麻醉在肥胖型PIH产妇剖宫产术效果

目的:探究超声定位下椎管内麻醉在肥胖型妊娠期高血压疾病(PIH)产妇剖宫产术效果.方法:随机数表法将本院2020年1月-2022年7月就诊的96例肥胖型PIH产妇分为观察组与对照组各48例,分别接受超声定位下椎管内麻醉或传统方法椎管内麻醉.对比两组穿刺情况、麻醉效果等指标.结果:观察组穿刺成功率(100%)与对照组(89.6%)无差异(P>0.05),穿刺相关并发症发生率(4.2%)低于对照组(20.1%),腰椎间隙定位时间(1.50±0.36 min)、麻醉穿刺时间(4.40±1.17min)、起效时间(11.70±2.24min)及穿刺次数(1.12±0.30次)均小于对照组(4.12±1.18min、7.25±1.20min、16.00±2.35min、1.84±0.50次),麻醉效果I级(97.9%)高于对照组I级(85.4%);两组麻醉用药后10min血压均下降但观察组变化幅度小于对照组;两组术后12h血清皮质醇、C肽、晚期氧化蛋白产物水平均上升但观察组变化幅度小于对照组(均P<0.05).两组新生儿脐动脉血血气指标、娩出后1min、5minApgar评分均无差异(P>0.05).结论:超声定位下椎管内麻醉用于肥胖型PIH产妇剖宫产术能提高穿刺成功率,减少相关并发症,对产妇血流动力学及应激激素影响小,麻醉效果好.

不同程度的PIH对妊娠结局的影响

目的探讨不同程度妊娠期高血压综合征疾病(PIH)对妊娠结局的影响。方法将南京市妇幼保健院2008年12月至2013年1月期间收治的256例妊娠期高血压综合征孕妇作为观察组,并选取同期住院的正常妊娠孕妇256例作为对照组,分别就观察组和对照组、不同程度观察组的妊娠结局进行回顾性分析研究。结果在256例观察组产妇中,妊娠期高血压、轻度子痫前期、重度子痫前期分别占49.61%、28.13%、22.27%。观察组产妇早产、剖宫产、胎盘早剥、产后出血、胎儿窘迫、新生儿窒息、围产儿死亡及低体重出生儿的发生率显著高于对照组(x^2值分别为13.20、88.44、6.07、8.15、9.31、33.12、4.03、12.60,均P<0.05)。子痫前期组孕妇早产、剖宫产、胎盘早剥、产后出血、胎儿出现窘迫、新生儿发生窒息、围产儿死亡及低体重出生儿的发生率明显高于妊娠期高血压组,经比较差并有统计学意义(x^2值分别为22.03、49.37、13.63、55.06、20.89、66.25,7.25,19.52,均P<0.05)。结论妊娠期高血压综合征疾病对母婴健康有严重影响,而且程度越重,对妊娠结局影响越大。大力普及孕期保健知识,早发现、早诊断、早治疗,及早控制病情,可有效改善母婴预后。

PIH患者测定血清cTnI和Mb的临床意义

目的:探讨妊娠高血压综合征(PIH)与心肌损伤的关系。方法:采用化学发光法测定39例PIH患者血清肌钙蛋白I(cTnI)和肌红蛋白(Mb)及39例正常孕妇血清cTnI和Mb的含量。结果:PIH伴蛋白尿组血清cTnI和Mb显著高于PIH不伴蛋白尿组及正常妊娠组(P<0.05),且随病情加重其值升高,PIH不伴蛋白尿组与正常妊娠组相比虽有升高趋势,但无统计学意义(P>0.05)。结论:PIH伴蛋白尿患者极易发生心肌损伤,因而及早检测、及早发现并治疗对临床极为重要。

肾功能指标与HDP脐动脉血流参数的关联及对不良预后的预测研究

目的:探究肾功能指标与妊娠期高血压(HDP)脐动脉血流参数的关联性以及对患者不良预后的预测效能。方法:选取2022年1月—2023年6月信阳市人民医院收治的58例HDP患者列为病例组,60例接受常规体检的孕妇列为对照组。比较两组对象肾功能指标及脐动脉血流参数,分析肾功能指标与脐动脉血流参数间的关联;将HDP患者分为预后不良组和预后良好组,分析肾功能指标对HDP不良预后的预测效能。结果:病例组尿酸(UA)、24 h尿蛋白(24 h PRO)、动脉搏动指数(PI)、阻力指数(RI)、收缩期峰值及舒张末期流速之比(S/D)高于对照组,差异均有统计学意义(t=5.693、5.692、31.537、12.508、19.012,P<0.05);UA、24 h PRO等肾功能指标与脐动脉PI、SI、S/D呈正相关(r=0.252、0.254、0.251;r=0.253、0.255、0.252);预后不良组患者的UA、24 h PRO、PI、SI、S/D均高于预后良好组,差异均有统计学意义(t=2.432、2.545、2.863、2.651、3.659,P<0.05);logistic回归分析结果显示,UA、24 h PRO、PI、RI、S/D为导致HDP发生不良预后的危险因素(OR=5.772、6.033、4.415、6.331、4.339);UA、24 h PRO水平越高,HDP不良预后风险越高。结论:UA、24 h PRO随着PI、SI、S/D等脐动脉血流指标升高而上升,对HDP不良预后有较高预测效能。

PIH患者血清D-二聚体及内皮素与脂肪因子水平及相关性研究

目的探讨妊娠高血压综合征患者血清D-二聚体及内皮素与脂肪因子关系及临床意义.方法选择PIH患者94例,分为轻度组42例、中度组34例、重度组18例.同时选择同期行健康体检的30例研究对象为对照组.分别检测各组的Chemerin、内脂素、瘦素及D-二聚体、内皮素的值,并进行统计学处理.结果轻度组患者Chemerin、内脂素较对照组差异有统计学意义(P<0.05),中度组患者Chemerin、内脂素、D-二聚体、内皮素较对照组及轻度组患者差异有统计学意义(P<0.05),瘦素较对照组差异有统计学意义(P<0.05).重度组患者Chemerin、内脂素、D-二聚体、内皮素较对照组及轻度组、中度组患者差异有统计学意义(P<0.05),瘦素较对照组、轻度组差异有统计学意义(P<0.05).D-二聚体与Chemerin及内脂素呈正相关(P<0.05),内皮素与Chemerin、内脂素、瘦素正相关(P<0.05).结论脂肪因子代谢紊乱是PIH发生的重要原因,并与血管内皮功能及凝血、纤溶系统密切相关.

硝苯地平联合硫酸镁对PIH患者血流动力学及妊娠结局的影响

目的探究硝苯地平联合硫酸镁对妊娠期高血压(PIH)患者血压、血流动力学及妊娠结局的影响。方法选取2015年6月至2017年9月在永康市妇幼保健院就诊的104例PIH患者为研究对象,采用随机数字表法分为对照组及观察组各52例。对照组给予镇静、利尿等基础治疗及硫酸镁治疗,观察组则在对照组的基础上予以硝苯地平治疗。比较两组治疗前及治疗7d后血压[收缩压(SBP)、舒张压(SDP)]、子宫动脉血流动力学指标[收缩期峰值流速(PSV)、搏动指数(PI)、阻力指数(RI)]、内皮功能指标[一氧化氮(NO)、内皮素-1(ET-1)、基质金属蛋白酶9(MMP9)]及母婴结局的差异。结果治疗7d后,两组血压(SBP、SDP)水平、子宫动脉血流动力学指标(PSV、PI、RI)、部分内皮功能指标(ET-1、MMP9)均较治疗前降低(观察组:t值分别为38.008、24.006、7.796、17.169、13.574、18.910、26.685;对照组:t值分别为29.625、15.757、4.227、10.489、8.484、13.680、22.024,均P<0.05),NO水平则较治疗前升高(观察组:t=20.159;对照组:t=14.036,均P<0.05),且观察组变化幅度均大于对照组(t值分别为5.233、4.842、2.065、3.693、2.713、4.228、4.054、4.778,均P<0.05)。两组孕母不良结局总发生率比较差异无统计学意义(P>0.05);观察组胎儿不良结局总发生率明显低于对照组(χ^2=4.887,P<0.05)。结论硝苯地平与硫酸镁联合应用对PIH患者血压改善效果显著,也能纠正子宫动脉血流动力学紊乱状态,并提高机体血管内皮功能,同时还能减少胎儿不良结局。