Efficacy and safety of combination of magnesium sulfate, phentolamine and nifedipine in treatment of patients with hypertensive disorder complicating pregnancy

Serum Macrophage Colony-Stimulating Factor Relates to the Severity and the Pregnancy Outcomes in Hypertensive Disorders Complicating Pregnancy

PURPOSE

This study aimed to assess the predictive value of macrophage colony-stimulating factor (M-CSF) in the first trimester for hypertensive disorders complicating pregnancy (HDCP) and its association with disease severity and adverse pregnancy outcomes. HDCP pose significant risks to both maternal health and fetal health. M-CSF is implicated in the pathogenesis of HDCP by promoting inflammation and endothelial damage.

METHODS

Serum levels of M-CSF were measured using an enzyme-linked immunosorbent assay, and clinical characteristics and pregnancy outcomes were compared between groups.

RESULTS

Pregnant women with HDCP had significantly higher levels of proteinuria, systolic blood pressure, and diastolic blood pressure compared to those with normal pregnancy. Among patients with HDCP, the severity of disease correlated positively with serum levels of M-CSF. Furthermore, M-CSF levels in the first trimester were significantly associated with adverse pregnancy outcomes. The findings suggest that M-CSF may serve as a potential biomarker for predicting HDCP and its severity, as well as adverse pregnancy outcomes.

CONCLUSIONS

Early detection and monitoring of M-CSF levels could aid in identifying high-risk pregnancies and implementing appropriate interventions to improve maternal and fetal outcomes.

Efficacy of aspirin combined with labetalol on gestational hypertension and effect on serum PAPP-A, APN and HMGB1

OBJECTIVE

To determine the clinical efficacy of aspirin combined with labetalol on gestational hypertension (GH) and its influence on serum pregnancy associated plasma protein-A (PAPP-A), adiponectin (APN), and high mobility group box-1 (HMGB1).

METHODS

A total of 146 patients with GH admitted to the Zibo Central Hospital between April 2018 and January 2020 were analyzed retrospectively. The control group (Con group, n=71) was treated by labetalol monotherapy, and on this basis, the research group (Res group, n=75) was additionally given aspirin. The following criteria of the 2 groups were evaluated: total effectiveness rate, incidence of adverse reactions, blood pressure-associated indices, coagulation function-associated indices, changes in serum PAPP-A, APN, and HMGB1 levels, adverse maternal and infant outcomes, and neonatal Apgar score.

RESULTS

After therapy, the Res group showed a notably higher total effective rate than the Con group, with no remarkable difference in the incidence of adverse reactions. Additionally, compared to the Con group, the Res group showed notably lower systolic blood pressure (SBP) and diastolic blood pressure (DBP), greatly improved coagulation function, significantly lower levels of serum PAPP-A and HMGB1, and significantly higher level of serum APN. Moreover, the incidence of adverse maternal and infant outcomes in the Res group was much lower than that in the Con group after therapy, and the one- and five-min Apgar scores of neonates in the Res group were both notably higher than those in the Con group after delivery.

CONCLUSION

For patients with GH, aspirin combined with labetalol can effectively control blood pressure, improve coagulation function and clinical efficacy, lower serum PAPP-A and HMGB1, and increase serum APN, and ameliorate maternal and infant outcome.