This study examined in vitro effect of lipoxin A 4 (LXA 4) on interleukin-1β (IL-1β) production of monocytes and its possible mechanism in severe preeclampsia (PE).Peripheral venous blood was drawn from 15 patients ...This study examined in vitro effect of lipoxin A 4 (LXA 4) on interleukin-1β (IL-1β) production of monocytes and its possible mechanism in severe preeclampsia (PE).Peripheral venous blood was drawn from 15 patients with severe preeclampsia (PE group) and 20 normal pregnant women (control group) to prepare monocytes which were then treated with LXA 4 at different concentrations of 0,10,100 nmol/L respectively.IL-1β level in the supernatant of monocytes was detected by enzyme linked immunoassay.The [Ca 2+ ] i of monocytes was measured by laser scanning confocal microscopy.The results showed that the IL-1β level and the [Ca 2+ ] i of monocytes in the PE group were significantly higher than those in the control group.LXA 4 significantly decreased the generation of IL-1β in a dose-dependent manner in the PE group.After treatment with 100-nmol/L LXA 4,in the PE group,the [Ca 2+ ] i concentration of monocytes was significantly reduced.It was concluded that LXA 4 may inhibit the IL-1β production of monocytes from severe preeclampsia women by inhibiting extracellular calcium influx.展开更多
Objective: The aim of this study was to determine maternal and perinatal complications of pregnancies complicated by severe preeclampsia in three tertiary care centers in Cameroon. Methods: We carried out a descriptiv...Objective: The aim of this study was to determine maternal and perinatal complications of pregnancies complicated by severe preeclampsia in three tertiary care centers in Cameroon. Methods: We carried out a descriptive cross sectional study from the 1st of June 2012 to the 31th of June 2014, among pregnant women with severe preeclampsia followed up in three tertiary level hospitals in Yaoundé, Cameroon: the Yaoundé General Hospital, the Yaoundé Central Hospital, and the Yaoundé University Hospital. Statistical analysis was performed using EPI 3.5.5. Data were described as means ± standard deviation, percentages and numbers. Chi-square and Fisher exact tests were used where appropriate. Results: Of the 2500 deliveries registered during the study period, 111 cases (8.49%) were managed as severe preeclampsia. Four patients refused to participate and were excluded from the study. Most of these patients were non workers (58.0%), pauciparous (61.7%) and young (median age of 27.47 years ± 6.46). Eclampsia (12.14%), abruptio placentae (11.21%) and hypertensive retinopathy (7.47%) were the most frequent maternal complications. Two cases (1.86%) of maternal deaths occurred in patients who had eclampsia. Prematurity (48.6%), intra uterine fetal death (13.1%) and oligoamnios (11.2%) were the most frequent fetal complications. All four neonatal deaths occurred in women in whom the diagnosis of severe preeclampsia was done between 28 and 33 weeks of gestation. Conclusion: Pregnancies complicated by severe preeclampsia had significantly high maternal and perinatal morbidity and mortality in Cameroon. The complications of severe preeclampsia can be prevented by more widespread use of antenatal care, education of primary medical care personnel, prompt diagnosis of high-risk patients and timely referral to tertiary medical centers.展开更多
Severe pre<span>e</span><span>clampsia is a challenging issue facing both intensivist and anesthetic team carrying both maternal and fetal morbidity and mortality. Termination of pregnancy after bloo...Severe pre<span>e</span><span>clampsia is a challenging issue facing both intensivist and anesthetic team carrying both maternal and fetal morbidity and mortality. Termination of pregnancy after blood pressure control is the golden key in management. Cerebral complications due to diffuse cerebral vasospasm are most common and serious. Intrathecal midazolam with its gamma amino butyric action may antidote glutamate mediated sympathetic surge and decreasing cerebral vasospasm. Temporal view transcranial Doppler imaging maternal middle cerebral artery is used to examine blood flow indices namely pulsat</span><span>i</span><span>lity index and resistiv</span><span>e</span><span> index. One hundred ladies with severe pre</span><span>e</span><span>clampsia scheduled for urgent caesarian section were recruited in 2 groups, both received 10</span><span> </span><span>mg bupivacaine 0.5%, Midazolam group received 1</span><span> </span><span>mg midazolam and the other group received 0.2</span><span> </span><span>ml sterile saline 0.9% NaCl. All vascular indices were significantly better in midazolam group, less ICU stay.</span>展开更多
Objective:To explore the correlation between the distribution of 14bp polymorphism in exon 8 of human leukocyte antigen-G(HLA-G)gene in Hainan Li nationality and susceptibility to severe preeclampsia.Methods:100 cases...Objective:To explore the correlation between the distribution of 14bp polymorphism in exon 8 of human leukocyte antigen-G(HLA-G)gene in Hainan Li nationality and susceptibility to severe preeclampsia.Methods:100 cases of severe preeclampsia inpatients(experimental group)admitted to our hospital from June 2018 to September 2019 were selected.Among them,50 were Li and 50 were Han,and 100 were admitted to our hospital during the same period Normal pregnant women were the control group,including 50 cases of Li nationality and 50 cases of Han nationality.Venous blood was collected to detect the 14bp polymorphism in HLA-G gene exon 8,and the correlation between the 14bp polymorphism in HLA-G gene exon 8 and susceptibility to severe preeclampsia was analyzed.Results:There was a statistically significant difference in the 14-bp genotyping and allele frequency in HLA-G exon 8 of the Li ethnic group in the control group and the experimental group(P<0.05).The SBP and DBP of the Li 14-14/14bp typing,+14bp/-14bp typing,and allele-14bp typing were lower in the experimental group than in the Han group in the experimental group(P<0.05),and the SBP of+14bp/-14bp typing DBP was higher than that of Han patients in the experimental group(P<0.05).Binary Logistic Regression Analysis+14bp/-14bp was associated with the incidence of severe preeclampsia in Li women in Hainan region(P<0.05).The-14bp/-14bp classification was a protective factor for severe preeclampsia in Li women in Hainan region(P<0.05).Conclusion:The HLA-G gene exon 8 carrying a 14bp deletion polymorphism in the Hainan Li nationality is associated with preeclampsia susceptibility and progression.展开更多
Objective:To study the influence of human albumin combined with low-dose heparin on disease condition, serology and placental blood flow of severe preeclampsia patients. Methods:A total of 78 patients with severe pree...Objective:To study the influence of human albumin combined with low-dose heparin on disease condition, serology and placental blood flow of severe preeclampsia patients. Methods:A total of 78 patients with severe preeclampsia in our hospital between May 2011 and February 2017 were chosen as study subjects, treatment methods were reviewed and all patients were divided into control group (n=37) who underwent low-dose heparin plus conventional treatment and observation group (n=41) who underwent human albumin combined with low-dose heparin plus conventional treatment, both lasting for 7 d. Before and after treatment, mean arterial pressure (MAP) and 24 h urinary protein were measured, serum markers of disease were measured by enzyme-linked immunosorbent assay (ELISA), and umbilical artery hemodynamics were detected by color Doppler ultrasound.Results:Before treatment, there was no significant difference between the two groups in MAP, 24 h urine protein, serum disease-related indexes or umbilical artery hemodynamic indexes. 7 d after treatment, MAP and 24 h urine protein levels in observation group were lower than those in control group;serum disease-related indexes TGF-β1 and VEGF contents in observation group were higher than those in control group whereas VCAM-1 and sFlt-1 contents were lower than those in control group;umbilical artery hemodynamic indexes PI, RI and S/D levels in observation group were lower than those in control group.Conclusion: Human albumin combined with low-dose heparin can optimize the disease condition, promote the angiogenesis of placenta and increase the blood supply of placenta in patients with severe preeclampsia.展开更多
Objective: To investigate the effect of magnesium sulfate combined with labetalol on the apoptosis and invasion molecule expression in placenta as well as maternal endothelial function of patients with severe preeclam...Objective: To investigate the effect of magnesium sulfate combined with labetalol on the apoptosis and invasion molecule expression in placenta as well as maternal endothelial function of patients with severe preeclampsia. Methods: A total of 68 patients with severe preeclampsia who were treated in the hospital between October 2015 and August 2017 were chosen as the research subjects and divided into study group (n=34) and control group (n=34) by random number table method. Control group received magnesium sulfate therapy on the basis of conventional therapy, and study group received magnesium sulfate combined with labetalol therapy on the basis of conventional therapy. The differences in the expression of apoptosis and invasion molecules in placenta tissue as well as the levels of maternal endothelial function indexes were compared between the two groups. Results: Fas, Bax and Caspase-3 mRNA expression in the placenta tissues of study group were lower than those of control group whereas Bcl-2 mRNA expression was higher than that of control group;GPR30, LAMA4 and MEST mRNA expression in placenta tissues were lower than those of control group whereas CDKN1C mRNA expression was higher than that of control group;24 h before delivery, maternal serum ET-1 and vWF levels of study group were lower than those of control group whereas NO level was higher than that of control group (P<0.05). Conclusion: Magnesium sulfate combined with labetalol therapy can effectively inhibit the apoptosis of placental trophoblast cells and enhance their invasion ability, and also improve the maternal endothelial function in patients with severe preeclampsia.展开更多
Objective:To study the effect of adjuvant low-molecular-weight heparin therapy on placental hypoxia and cell apoptosis in puerperae with severe preeclampsia.Methods:A total of 94 puerperae with severe preeclampsia who...Objective:To study the effect of adjuvant low-molecular-weight heparin therapy on placental hypoxia and cell apoptosis in puerperae with severe preeclampsia.Methods:A total of 94 puerperae with severe preeclampsia who received treatment and safely gave birth in our hospital between May 2014 and May 2016 were selected as the research subjects and randomly divided into the LMWH group who received low-molecular-weight heparin combined with conventional symptomatic treatment and the control group who received conventional symptomatic treatment. Before and after treatment, serum was collected respectively to determine the levels of placental hypoxia-related cytokines, and after delivery, the placentas were collected to detect oxidative stress indexes and cell apoptosis indexes.Results: After treatment, serum PLGF and PAPP-A levels of both groups were significantly higher than those before treatment while sFlt-1 and sEng levels were significantly lower than those before treatment, and after treatment, serum PLGF and PAPP-A levels of LMWH group were significantly higher than those of control group while sFlt-1 and sEng levels were significantly lower than those of control group;ROS and RNS levels as well as Fas, FasL, caspase-3 and caspase-8 protein expression in placenta tissue of LMWH group were significantly lower than those of control group while GPx-1, SOD-1 and Trx levels as well as Survivin, XIAP and Bcl-2 protein expression were significantly higher than those of control group.Conclusion:Adjuvant low-molecular-weight heparin therapy can relieve the placental hypoxia, improve oxidative stress reaction and inhibit cell apoptosis in puerperae with severe preeclampsia.展开更多
Background: Severe preeclampsia with acute pulmonary oedema possesses great challenges to the anaesthetist. If not well managed, it could be associated with high maternal morbidity and mortality rate as well as fetal ...Background: Severe preeclampsia with acute pulmonary oedema possesses great challenges to the anaesthetist. If not well managed, it could be associated with high maternal morbidity and mortality rate as well as fetal wastage. Aim: To sensitize the anaesthetist that when confronted with such a dilemma, well managed low spinal block can be a useful and successful anaesthetic technique. Methods: We report the case of a 23-year-old primigravida with twins gestation at 36 weeks, who presented with severe ante-partum pre-eclapsia, acute pulmonary oedema and acute heart failure. Blood investigations done were normal, and clotting time was within normal range. Her clinical conditions were optimized through a well thoughtful medication after which a low dose spinal anesthesia was performed using 1.5 mls (7.5 mg) of 0.5% hyperbaric bupivacaine (Modified saddle). The baby was delivered through a low segment caesarean section. Conclusion: The procedure was well tolerated and successful. Low spinal is associated with low incidence of hypotension and do not require pre-loading.展开更多
Background: Severe preeclampsia with acute pulmonary oedema possesses great challenges to the anaesthetist. If not well managed, it could be associated with high maternal morbidity and mortality rate as well as fetal ...Background: Severe preeclampsia with acute pulmonary oedema possesses great challenges to the anaesthetist. If not well managed, it could be associated with high maternal morbidity and mortality rate as well as fetal wastage. Aim: To sensitize the anaesthetist that when confronted with such a dilemma, well managed low spinal block can be a useful and successful anaesthetic technique. Methods: We report the case of a 23-year-old primigravida with twins gestation at 36 weeks, who presented with severe ante-partum pre-eclapsia, acute pulmonary oedema and acute heart failure. Blood investigations done were normal, and clotting time was within normal range. Her clinical conditions were optimized through a well thoughtful medication after which a low dose spinal anesthesia was performed using 1.5 mls (7.5 mg) of 0.5% hyperbaric bupivacaine (Modified saddle). The baby was delivered through a low segment caesarean section. Conclusion: The procedure was well tolerated and successful. Low spinal is associated with low incidence of hypotension and do not require pre-loading.展开更多
Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is charact...Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is characterized by a poor maternal and fetal prognosis. EOP has a disparate incidence in the world varying between 0.9% and 31%. Several risks factors are associated with the occurrence of EOP, which is responsible of several adverse obstetrical outcomes. Complications can affect up to 85% of pregnant women with EOP, especially when EOP appears very early, before 28 or even 25 weeks’ gestation. Objectives: To determine frequency of EOP at the University Clinics of Kinshasa, to describe sociodemographic and clinical characteristics of pregnant women with EOP and to identify its risks factors and its association adverse obstetrical outcomes. Methods: The study will be a cross-sectional analytical study in University Clinics of Kinshasa from January 2016 to December 2022. The minimal size will be 119. Our study population will consist of pregnant women who consult for antenatal best care and are neonates in our Clinic. Result will be presented as percentage proportion. Comparison and proportion means between groups will be made using Student’s test and Pearson’s chi-square test, respectively. Our test will be statistically significant for a p-value ≤ than less 0.05. Data will be collected and analysed anonymously and confidentiality. Conclusion: We believe that our study should enable us to identify profile of gestational carriers at risk of EOP in our environment, as well as prognosis associated with this entity, with a view to arousing particular interest in EOP.展开更多
目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组...目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组给予拉贝洛尔联合低分子肝素治疗。比较两组治疗前后凝血功能指标、血压、血脂水平、母婴结局、新生儿Apgar评分及不良反应发生情况。结果治疗后,B组凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)均长于A组,新生儿5、10 min Apgar评分均高于A组,纤维蛋白原(FIB)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平及不良新生儿结局、不良妊娠结局发生率均低于A组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论拉贝洛尔联合低分子肝素治疗早发型重度子痫前期,可改善患者凝血功能、血脂及血压水平,改善母婴结局,且安全性较高。展开更多
文摘This study examined in vitro effect of lipoxin A 4 (LXA 4) on interleukin-1β (IL-1β) production of monocytes and its possible mechanism in severe preeclampsia (PE).Peripheral venous blood was drawn from 15 patients with severe preeclampsia (PE group) and 20 normal pregnant women (control group) to prepare monocytes which were then treated with LXA 4 at different concentrations of 0,10,100 nmol/L respectively.IL-1β level in the supernatant of monocytes was detected by enzyme linked immunoassay.The [Ca 2+ ] i of monocytes was measured by laser scanning confocal microscopy.The results showed that the IL-1β level and the [Ca 2+ ] i of monocytes in the PE group were significantly higher than those in the control group.LXA 4 significantly decreased the generation of IL-1β in a dose-dependent manner in the PE group.After treatment with 100-nmol/L LXA 4,in the PE group,the [Ca 2+ ] i concentration of monocytes was significantly reduced.It was concluded that LXA 4 may inhibit the IL-1β production of monocytes from severe preeclampsia women by inhibiting extracellular calcium influx.
文摘Objective: The aim of this study was to determine maternal and perinatal complications of pregnancies complicated by severe preeclampsia in three tertiary care centers in Cameroon. Methods: We carried out a descriptive cross sectional study from the 1st of June 2012 to the 31th of June 2014, among pregnant women with severe preeclampsia followed up in three tertiary level hospitals in Yaoundé, Cameroon: the Yaoundé General Hospital, the Yaoundé Central Hospital, and the Yaoundé University Hospital. Statistical analysis was performed using EPI 3.5.5. Data were described as means ± standard deviation, percentages and numbers. Chi-square and Fisher exact tests were used where appropriate. Results: Of the 2500 deliveries registered during the study period, 111 cases (8.49%) were managed as severe preeclampsia. Four patients refused to participate and were excluded from the study. Most of these patients were non workers (58.0%), pauciparous (61.7%) and young (median age of 27.47 years ± 6.46). Eclampsia (12.14%), abruptio placentae (11.21%) and hypertensive retinopathy (7.47%) were the most frequent maternal complications. Two cases (1.86%) of maternal deaths occurred in patients who had eclampsia. Prematurity (48.6%), intra uterine fetal death (13.1%) and oligoamnios (11.2%) were the most frequent fetal complications. All four neonatal deaths occurred in women in whom the diagnosis of severe preeclampsia was done between 28 and 33 weeks of gestation. Conclusion: Pregnancies complicated by severe preeclampsia had significantly high maternal and perinatal morbidity and mortality in Cameroon. The complications of severe preeclampsia can be prevented by more widespread use of antenatal care, education of primary medical care personnel, prompt diagnosis of high-risk patients and timely referral to tertiary medical centers.
文摘Severe pre<span>e</span><span>clampsia is a challenging issue facing both intensivist and anesthetic team carrying both maternal and fetal morbidity and mortality. Termination of pregnancy after blood pressure control is the golden key in management. Cerebral complications due to diffuse cerebral vasospasm are most common and serious. Intrathecal midazolam with its gamma amino butyric action may antidote glutamate mediated sympathetic surge and decreasing cerebral vasospasm. Temporal view transcranial Doppler imaging maternal middle cerebral artery is used to examine blood flow indices namely pulsat</span><span>i</span><span>lity index and resistiv</span><span>e</span><span> index. One hundred ladies with severe pre</span><span>e</span><span>clampsia scheduled for urgent caesarian section were recruited in 2 groups, both received 10</span><span> </span><span>mg bupivacaine 0.5%, Midazolam group received 1</span><span> </span><span>mg midazolam and the other group received 0.2</span><span> </span><span>ml sterile saline 0.9% NaCl. All vascular indices were significantly better in midazolam group, less ICU stay.</span>
基金Medical and health research project of Hainan Provincial(1901031027A2001)
文摘Objective:To explore the correlation between the distribution of 14bp polymorphism in exon 8 of human leukocyte antigen-G(HLA-G)gene in Hainan Li nationality and susceptibility to severe preeclampsia.Methods:100 cases of severe preeclampsia inpatients(experimental group)admitted to our hospital from June 2018 to September 2019 were selected.Among them,50 were Li and 50 were Han,and 100 were admitted to our hospital during the same period Normal pregnant women were the control group,including 50 cases of Li nationality and 50 cases of Han nationality.Venous blood was collected to detect the 14bp polymorphism in HLA-G gene exon 8,and the correlation between the 14bp polymorphism in HLA-G gene exon 8 and susceptibility to severe preeclampsia was analyzed.Results:There was a statistically significant difference in the 14-bp genotyping and allele frequency in HLA-G exon 8 of the Li ethnic group in the control group and the experimental group(P<0.05).The SBP and DBP of the Li 14-14/14bp typing,+14bp/-14bp typing,and allele-14bp typing were lower in the experimental group than in the Han group in the experimental group(P<0.05),and the SBP of+14bp/-14bp typing DBP was higher than that of Han patients in the experimental group(P<0.05).Binary Logistic Regression Analysis+14bp/-14bp was associated with the incidence of severe preeclampsia in Li women in Hainan region(P<0.05).The-14bp/-14bp classification was a protective factor for severe preeclampsia in Li women in Hainan region(P<0.05).Conclusion:The HLA-G gene exon 8 carrying a 14bp deletion polymorphism in the Hainan Li nationality is associated with preeclampsia susceptibility and progression.
文摘Objective:To study the influence of human albumin combined with low-dose heparin on disease condition, serology and placental blood flow of severe preeclampsia patients. Methods:A total of 78 patients with severe preeclampsia in our hospital between May 2011 and February 2017 were chosen as study subjects, treatment methods were reviewed and all patients were divided into control group (n=37) who underwent low-dose heparin plus conventional treatment and observation group (n=41) who underwent human albumin combined with low-dose heparin plus conventional treatment, both lasting for 7 d. Before and after treatment, mean arterial pressure (MAP) and 24 h urinary protein were measured, serum markers of disease were measured by enzyme-linked immunosorbent assay (ELISA), and umbilical artery hemodynamics were detected by color Doppler ultrasound.Results:Before treatment, there was no significant difference between the two groups in MAP, 24 h urine protein, serum disease-related indexes or umbilical artery hemodynamic indexes. 7 d after treatment, MAP and 24 h urine protein levels in observation group were lower than those in control group;serum disease-related indexes TGF-β1 and VEGF contents in observation group were higher than those in control group whereas VCAM-1 and sFlt-1 contents were lower than those in control group;umbilical artery hemodynamic indexes PI, RI and S/D levels in observation group were lower than those in control group.Conclusion: Human albumin combined with low-dose heparin can optimize the disease condition, promote the angiogenesis of placenta and increase the blood supply of placenta in patients with severe preeclampsia.
文摘Objective: To investigate the effect of magnesium sulfate combined with labetalol on the apoptosis and invasion molecule expression in placenta as well as maternal endothelial function of patients with severe preeclampsia. Methods: A total of 68 patients with severe preeclampsia who were treated in the hospital between October 2015 and August 2017 were chosen as the research subjects and divided into study group (n=34) and control group (n=34) by random number table method. Control group received magnesium sulfate therapy on the basis of conventional therapy, and study group received magnesium sulfate combined with labetalol therapy on the basis of conventional therapy. The differences in the expression of apoptosis and invasion molecules in placenta tissue as well as the levels of maternal endothelial function indexes were compared between the two groups. Results: Fas, Bax and Caspase-3 mRNA expression in the placenta tissues of study group were lower than those of control group whereas Bcl-2 mRNA expression was higher than that of control group;GPR30, LAMA4 and MEST mRNA expression in placenta tissues were lower than those of control group whereas CDKN1C mRNA expression was higher than that of control group;24 h before delivery, maternal serum ET-1 and vWF levels of study group were lower than those of control group whereas NO level was higher than that of control group (P<0.05). Conclusion: Magnesium sulfate combined with labetalol therapy can effectively inhibit the apoptosis of placental trophoblast cells and enhance their invasion ability, and also improve the maternal endothelial function in patients with severe preeclampsia.
文摘Objective:To study the effect of adjuvant low-molecular-weight heparin therapy on placental hypoxia and cell apoptosis in puerperae with severe preeclampsia.Methods:A total of 94 puerperae with severe preeclampsia who received treatment and safely gave birth in our hospital between May 2014 and May 2016 were selected as the research subjects and randomly divided into the LMWH group who received low-molecular-weight heparin combined with conventional symptomatic treatment and the control group who received conventional symptomatic treatment. Before and after treatment, serum was collected respectively to determine the levels of placental hypoxia-related cytokines, and after delivery, the placentas were collected to detect oxidative stress indexes and cell apoptosis indexes.Results: After treatment, serum PLGF and PAPP-A levels of both groups were significantly higher than those before treatment while sFlt-1 and sEng levels were significantly lower than those before treatment, and after treatment, serum PLGF and PAPP-A levels of LMWH group were significantly higher than those of control group while sFlt-1 and sEng levels were significantly lower than those of control group;ROS and RNS levels as well as Fas, FasL, caspase-3 and caspase-8 protein expression in placenta tissue of LMWH group were significantly lower than those of control group while GPx-1, SOD-1 and Trx levels as well as Survivin, XIAP and Bcl-2 protein expression were significantly higher than those of control group.Conclusion:Adjuvant low-molecular-weight heparin therapy can relieve the placental hypoxia, improve oxidative stress reaction and inhibit cell apoptosis in puerperae with severe preeclampsia.
文摘Background: Severe preeclampsia with acute pulmonary oedema possesses great challenges to the anaesthetist. If not well managed, it could be associated with high maternal morbidity and mortality rate as well as fetal wastage. Aim: To sensitize the anaesthetist that when confronted with such a dilemma, well managed low spinal block can be a useful and successful anaesthetic technique. Methods: We report the case of a 23-year-old primigravida with twins gestation at 36 weeks, who presented with severe ante-partum pre-eclapsia, acute pulmonary oedema and acute heart failure. Blood investigations done were normal, and clotting time was within normal range. Her clinical conditions were optimized through a well thoughtful medication after which a low dose spinal anesthesia was performed using 1.5 mls (7.5 mg) of 0.5% hyperbaric bupivacaine (Modified saddle). The baby was delivered through a low segment caesarean section. Conclusion: The procedure was well tolerated and successful. Low spinal is associated with low incidence of hypotension and do not require pre-loading.
文摘Background: Severe preeclampsia with acute pulmonary oedema possesses great challenges to the anaesthetist. If not well managed, it could be associated with high maternal morbidity and mortality rate as well as fetal wastage. Aim: To sensitize the anaesthetist that when confronted with such a dilemma, well managed low spinal block can be a useful and successful anaesthetic technique. Methods: We report the case of a 23-year-old primigravida with twins gestation at 36 weeks, who presented with severe ante-partum pre-eclapsia, acute pulmonary oedema and acute heart failure. Blood investigations done were normal, and clotting time was within normal range. Her clinical conditions were optimized through a well thoughtful medication after which a low dose spinal anesthesia was performed using 1.5 mls (7.5 mg) of 0.5% hyperbaric bupivacaine (Modified saddle). The baby was delivered through a low segment caesarean section. Conclusion: The procedure was well tolerated and successful. Low spinal is associated with low incidence of hypotension and do not require pre-loading.
文摘Background: Preeclampsia (PE) is one of the forms of hypertensive diseases that occur during pregnancy. Early-onset preeclampsia (EOP), which occurred before 34 weeks, proved to be the deadliest. Indeed, it is characterized by a poor maternal and fetal prognosis. EOP has a disparate incidence in the world varying between 0.9% and 31%. Several risks factors are associated with the occurrence of EOP, which is responsible of several adverse obstetrical outcomes. Complications can affect up to 85% of pregnant women with EOP, especially when EOP appears very early, before 28 or even 25 weeks’ gestation. Objectives: To determine frequency of EOP at the University Clinics of Kinshasa, to describe sociodemographic and clinical characteristics of pregnant women with EOP and to identify its risks factors and its association adverse obstetrical outcomes. Methods: The study will be a cross-sectional analytical study in University Clinics of Kinshasa from January 2016 to December 2022. The minimal size will be 119. Our study population will consist of pregnant women who consult for antenatal best care and are neonates in our Clinic. Result will be presented as percentage proportion. Comparison and proportion means between groups will be made using Student’s test and Pearson’s chi-square test, respectively. Our test will be statistically significant for a p-value ≤ than less 0.05. Data will be collected and analysed anonymously and confidentiality. Conclusion: We believe that our study should enable us to identify profile of gestational carriers at risk of EOP in our environment, as well as prognosis associated with this entity, with a view to arousing particular interest in EOP.
文摘目的探究拉贝洛尔联合低分子肝素对早发型重度子痫前期孕妇凝血功能及血压影响。方法选取2021年1月至2022年7月济南市第一人民医院收治的80例早发型重度子痫前期患者作为研究对象,随机分为A组与B组,每组40例。A组给予拉贝洛尔治疗,B组给予拉贝洛尔联合低分子肝素治疗。比较两组治疗前后凝血功能指标、血压、血脂水平、母婴结局、新生儿Apgar评分及不良反应发生情况。结果治疗后,B组凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)均长于A组,新生儿5、10 min Apgar评分均高于A组,纤维蛋白原(FIB)、收缩压(SBP)、舒张压(DBP)、甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平及不良新生儿结局、不良妊娠结局发生率均低于A组,差异有统计学意义(P<0.05)。两组不良反应发生率比较差异无统计学意义。结论拉贝洛尔联合低分子肝素治疗早发型重度子痫前期,可改善患者凝血功能、血脂及血压水平,改善母婴结局,且安全性较高。