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| Effect of labetalol combined with low molecular heparin for treating pregnant women with early-onset severe preeclampsia and it influence on their urinary protein level,maternal and infant outcomes |
| Jiaxing Maternal and Child Health Care Hospital, Jiaxing, Zhejiang Province, 314051 |
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Abstract To investigate the efficacy of labetalol combined with low molecular heparin for treating pregnant women with early-onset severe preeclampsia, and to study it influence on the urinary protein level and their maternal and infant outcomes of these women. Methods: 112 pregnant women with early-onset severe preeclampsia who would delivery in hospital from January 2020 to June 2021 were selected prospectively and were divided into two groups (56 cases in each group) according to the random number table method. The women in the control group were treated with labetalol combined with magnesium sulfate, and the women in the study group were treated with labetalol and magnesium sulfate combined with low molecular heparin. The clinical efficacy before treatment and 1 week after treatment, the incidence of adverse reaction during treatment, the levels of serum angiotensin Ⅱ (Ang Ⅱ) and lipid per oxidation (LPO), the values of blood diastolic pressure (DP), blood systolic pressure (SP), and 24h proteinuria, the maternal and infant outcomes, and the difference of coagulation function of the were compared between the two groups. Results: After 1 week of treatment, the effective rate (96.4%) of the women in the study group was significantly higher than that (83.9%) of the women in the control group (P<0.05). During treatment, there were women with nausea, vomiting, fatigue, headache, fever, and other adverse reactions in both groups, and of the women in the control group also had rash, constipation, and other adverse reactions. The incidence of adverse reactions (12.5%) of the women in the study group was significantly lower than that (28.6%) of the women in the control group (P<0.05). 1 week after treatment, the levels of AngⅡ and LOP of the women in the two groups had decreased significantly, and which (9.65±1.31 nmol/L) of the women in the study group was significantly lower than that (13.43±2.24 nmol/L) of the women in the control group. The values of DP and SP, and the 24h proteinuria of the women in both groups had decreased significantly, and which (83.42±2.52 mmHg, 132.76±5.98 mmHg, and 1.12±0.36 g) of the women in the study group were significantly lower than those (88.75±2.54 mmHg, 140.54±5.98mmHg, and 1.91±0.61 g) of the women in the control group (all P<0.05). The incidences of preterm birth (1.8%), postpartum hemorrhage (3.6%), neonatal asphyxia (1.8%), placental abruption (3.6%), and fetal distress (3.6%) of the women in the study group were significantly lower than those (5.4%, 8.9%, 14.3%, 16.1%, and 16.1%) of the women in the control group. The incidences of neonatal asphyxia, placental abruption, and fetal distress of the women in the control group were significantly higher than those of the women in the study group (all P<0.05). After treatment, the levels of prothrombin time and thrombin time of the women in the study group had increased significantly, while the levels of plasma fibrinogen and D-dimer had decreased significantly, and the improving degrees of which (12.43±1.67s, 17.96±2.51s, 3.51± 1.04g /L, and 0.48± 0.11mg /ml) of the women in the study group were significantly better than those (10.99±1.33s, 16.59±2.21s, 4.62± 1.09g /L, and 0.92±0.22mg/mL) of the women in the control group (P<0.05). Conclusion: Labetalol combined with low molecular heparin for treating pregnant women with early-onset severe preeclampsia can increase the curative effect, can reduce the incidence of adverse reactions during the treatment, can improve the levels of serum AngⅡ and LOP, and can decrease the values of DP, SP, and 24h proteinuria, which can improve the maternal and infant outcomes. Conclusion: Labetalol combined with low molecular weight heparin sodium is effective in the treatment of early-onset severe preeclampsia. It can improve the indexes of serum ang Ⅱ and lop, reduce the DP, SP, and 24h proteinuria values, and can improve the maternal and infant adverse outcomes.
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