Epidural therapy for the treatment of severe pre-eclampsia in non labouring women

Ray, Amita; Ray, Sujoy

doi:10.1002/14651858.cd009540.pub2

Cited by 7 publications

(3 citation statements)

References 49 publications

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“…SPE is a common complication of pregnancy-induced hypertension, and its pathogenesis may be related to genetics, diet, immune regulation, and other factors, resulting in elevated blood pressure and inadequate placental perfusion [14]. If the treatment is not given timely, it can lead to abortion and even pose a threat to the life safety of pregnant women and fetuses [15]. erefore, early detection and early treatment are very important to improve outcomes in mother and infant.…”

Section: Discussionmentioning

confidence: 99%

Clinical Effects of Integrated Traditional Chinese and Western Medicine in Treating Severe Preeclampsia and Its Influence on Maternal and Infant Outcomes after Cesarean Section under Combined Lumbar and Epidural Anesthesia

Wang

Wei

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. This study is aimed to observe the clinical effects of integrated traditional Chinese and Western medicine in treating severe preeclampsia (SPE) and its effects on maternal and infant outcomes after cesarean section under combined lumbar and epidural anesthesia. Method. One hundred and sixty-six pregnant women with SPE were randomly divided into an experimental group and control group, with 83 cases in each group. The control group was given conventional treatments such as magnesium sulfate, and the experimental group received self-made traditional Chinese medicine decoction for oral administration. Results. The total clinical effective rate of treatment in the experimental group was significantly higher than that in the control group. After treatment, the systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and 24 h proteinuria (24 h PRO) levels of the experimental group were significantly lower than those of the control group. After cesarean section (c-section) under combined lumbar and epidural anesthesia, there were statistically significant differences in placental abruption, uterine weakness, fetal intrauterine distress, and neonatal asphyxia in the experimental group, while there were no significant differences in oligohydramnios. After treatment, the contents of inflammatory factors in both groups decreased, and the decrease was more prominent in the experimental group. After treatment, the levels of blood urea nitrogen (BUN), serum creatinine (Scr), and albumin (Alb) and β2 microglobulin (β2-MG) of the two groups of patients decreased, and the levels of them in the experimental group decreased. After treatment, the levels of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the two groups increased. However, the levels of malondialdehyde (MDA), lipid peroxide (LPO), and advanced oxidation protein products (AOPP) all reduced, and the increase or decrease in the experimental group was more prominent. Conclusion. The combination of traditional Chinese and Western medicine can reduce the blood pressure of a patient with SPE. After the combined spinal-epidural anesthesia and cesarean section, it can significantly improve the maternal and infant outcomes and renal function, reduce inflammatory factors levels and body oxidative stress, and increase the activities of antioxidant enzymes.

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Section: Discussionmentioning

confidence: 99%

Clinical Effects of Integrated Traditional Chinese and Western Medicine in Treating Severe Preeclampsia and Its Influence on Maternal and Infant Outcomes after Cesarean Section under Combined Lumbar and Epidural Anesthesia

Wang

Wei

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…Multimodal analgesia strategies for pain control should promote rapid recovery and ambulation and minimise the need for postoperative opioids [57]. Epidural analgesia can be continued for postoperative pain management to avoid or reduce the dose of drugs with renal elimination, such as morphine [58]. Pain control strategies include neuraxial morphine or hydromorphone, transverse abdominis plane (TAP) blocks, quadratus lumborum blocks, acetaminophen, and systemic opioids.…”

Section: B Postoperative and Postpartum Pain Managementmentioning

confidence: 99%

Renal Dysfunction in Pre-eclampsia: Etiology, Pathogenesis, Diagnosis and Perioperative Management: A Narrative Review

Ahmed

Kily²,

Valappil³

et al. 2022

EJMED

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Preeclampsia and preeclampsia-associated renal dysfunction (PARD) are severe morbidities during pregnancy with potentially devastating maternal and fetal outcomes. PARD has various aetiologies; understanding the physiological renal adaptation during pregnancy is paramount for early detection, diagnosis, and appropriate management to minimise maternal and fetal morbidities and mortalities. In this article, we review the current medical literature on PARD. We conducted a literature review using PubMed MEDLINE and ScienceDirect electronic databases. We accessed published work on the pathogenesis of renal dysfunction in preeclampsia and its management from 2005 to 2020. We aimed to highlight possible perioperative management strategies based on the pathophysiological derangements of preeclampsia. We used the following search terms: preeclampsia, renal dysfunction, pathogenesis, and perioperative management. Most of the studies we reviewed were either observational (both prospective and retrospective) or translational research studies. We also outline the primary perioperative (peri-delivery) course and discuss management options as advised by leading international societies and their challenges and considerations.

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“…Проблема профилактики и лечения преэклампсии, а также оценка тяжести течения и перинатальных рисков, во многом обусловлена отсутствием единого мнения медицинского сообщества о ее этиологии и патогенезе, хотя изучению данного осложнения беременности посвящено чрезвычайное количество исследований по всему миру [7,8]. При этом все чаще преэклампсия рассматривается с точки зрения эндотелиальной дисфункции [9][10][11], одним из механизмов развития которой является «оксидантный стресс» как ОРИГИНАЛЬНАЯ СТАТЬЯ ISSN 2307-9266 e-ISSN 2413-2241 Том 8, Выпуск 5, 2020 результат истощения антиоксидантной системы в условиях ишемии плаценты [12,13]. Развивающаяся на этом фоне эндотелиальная дисфункция приводит к нарушению микроциркуляции и гипоксии тканей и, как следствие, к развитию полиорганных поражений, составляющих клинические проявления преэклампсии [14][15][16].…”

Section: Introductionunclassified

Correction of Morphofunctional Disorders in Experimental Preeclampsy by Combined Use of Trimetazidine and Purified Micronized Flavonoid Fraction as Well as Their Combinations With Methylampsy

Анциферова

Телещенко

Цуверкалова

et al. 2021

Farm. farmakol. (Pâtigorsk)

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The aim of the experiment was to determine the effectiveness of the combined use of trimetazidine and a purified micronized flavonoid fraction, as well as their combinations with methyldopa, in comparison with monotherapy with the same drugs in the correction of morphofunctional disorders arising in the conditions of experimental preeclampsia. An integrated/multimethodology approach is the most effective way of treatment for preeclampsia. Therefore, an urgent task of modern pharmacology is to study the effectiveness of new drugs when used in combinations, as well as the drugs included in the standards for treatment.Materials and methods. The study was carried out at the Research Institute of Pharmacology of Living Systems of Belgorod State National Research University. The experiment was performed on 200 female Wistar rats, weighing 250–300 g, in which an ADMA-like model of preeclampsia had been reproduced. To assess the degree of correction of emerging morphological and functional disorders, the following parameters were involved: blood pressure, a coefficient of endothelial dysfunction, microcirculation in the placenta, proteinuria, fluid contents in the greater omentum, morphometric indicators of placental tissues and fetal height and weight parameters.Results. The combined use of trimetazidine (Preductal® MB) 6 mg/kg and a purified micronized flavonoid fraction (Detralex®) 260 mg/kg, as well as their combination with methyldopa (Dopegit®) 86 mg/kg, leads to a more pronounced decrease in the blood pressure, compared with a decrease in the coefficient of endothelial dysfunction by 2.22, 2.19 and 1.94 times, respectively, in relation to “untreated” animals. There was an increase in microcirculation indices in the placenta by 2.35, 2.21 and 2.03 times, respectively. In addition, there was an improvement in morphological parameters in the placenta and fetuses.Conclusion. The results of the study showed a greater effectiveness of the combined use of the studied drugs in experimental preeclampsia compared to their monotherapy. This indicates the prospects for the use of trimetazidine and purified micronized flavonoid fraction in the complex therapy for preeclampsia and the need for further research in this direction.

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Epidural therapy for the treatment of severe pre-eclampsia in non labouring women

Abstract: Ray A, Ray S. Epidural therapy for the treatment of severe pre-eclampsia in non labouring women.

Cited by 7 publications

References 49 publications

Clinical Effects of Integrated Traditional Chinese and Western Medicine in Treating Severe Preeclampsia and Its Influence on Maternal and Infant Outcomes after Cesarean Section under Combined Lumbar and Epidural Anesthesia

Clinical Effects of Integrated Traditional Chinese and Western Medicine in Treating Severe Preeclampsia and Its Influence on Maternal and Infant Outcomes after Cesarean Section under Combined Lumbar and Epidural Anesthesia

Renal Dysfunction in Pre-eclampsia: Etiology, Pathogenesis, Diagnosis and Perioperative Management: A Narrative Review

Correction of Morphofunctional Disorders in Experimental Preeclampsy by Combined Use of Trimetazidine and Purified Micronized Flavonoid Fraction as Well as Their Combinations With Methylampsy

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