Role of Calcium Levels in Pregnant Women with Pre-Eclampsia and Severe Pre-Eclampsia
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Objective: To determine the association between hypocalcemia and pre-eclampsia. Study Design: Case-control study. Place and Duration of Study: Department of Obstetrics Gynaecology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jul 2019. Methodology: A total of 90 women, (45 with pre-eclampsia and 45 with normotensive) aged 18-40 years, were included. In all patients, 5ml of venous blood was collected and sent to an institutional pathology laboratory for serum calcium level measurement. Hypocalcemia was noted in the patients. Results: The mean gestational age in the Case-Group was 31.40±1.64 weeks, and in the Control-Group was 31.51±1.69 weeks. The mean BMI in the Case-Group was 24.94±4.39 kg/m2, and in the Control-Group was 24.24±4.61 kg/m2. The mean serum calcium levels in the Case-Group were 5328.73±2638.70 ng/ml, and in the Control-Group were 8630.03±1099.26 ng/ml. In our study, the frequency of hypocalcemia in women with pre-eclampsia (Case Group) was found to be 16(36.56%) compared to only 04(8.89%) in normotensive (Control Group) women with a p-value of 005 and Odds ratio of 5.66 which shows a positive association of hypocalcemia with pre-eclampsia. Conclusion: This study concluded that the frequency of hypocalcemia in pre-eclampsia women is very high, which shows a positive association between hypocalcemia and pre-eclampsia.Keywords:
Venous blood
This chapter contains sections titled: Introduction Etiology of pre - eclampsia Diagnosis of pre - eclampsia General management principles for pre - eclampsia Fluid therapy for pre - eclampsia Seizure prophylaxis for pre - eclampsia Antihypertensive therapy for severe pre - eclampsia Analgesia – anesthesia for pre - eclampsia Hemodynamic monitoring for pre - eclampsia Cardiopulmonary complications of pre - eclampsia Renal complications of pre - eclampsia HELLP syndrome Liver rupture Pancreatitis Neurologic complications of pre - eclampsia Eclampsia Uteroplacental – fetal complications of pre - eclampsia Conclusions References
HELLP syndrome
Etiology
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Maternal morbidity
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Background: The present study was conducted with an aim to Study the relevant Laboratory investigations in cases of Pre-eclampsia of in Department of Obstetrics and Gynecology, Index Medical College Hospital & Research Centre, Indore M.P. Result: From the observation Table No. 1 it is clear that platelet count was < 1 Lac /cu mm in 14.07% of mild pre-eclampsia, 72% of severe pre-eclampsia and 75% of eclampsia patients. From the observation Table No.2 it is clear that total bilirubin was > 1.2 mg/dl in 4.68% of mild pre-eclampsia, 30% of severe pre-eclampsia and 34.37% of eclampsia patients.From the observation Table No.3 it is clear that SGOT was > 72 IU/L in 1.57% of mild pre-eclampsia, 14% of severe pre-eclampsia and 21.88% of eclampsia patients. From the observation Table No.4 it is clear that SGPT was > 72 IU/L in 3.13% of mild pre-eclampsia, 12% of severe pre-eclampsia and 18.75% of eclampsia patients. Conclusion: Platelet count was found to be <1 lac / cumm in significant number of severe pre-eclampsia and eclampsia patients in comparison to control group. Hyperbilirubinemia was seen in small groups of pre-eclampsia and eclampsia patients. Deranged liver enzyme levels were also found in small group of pre-eclampsia and eclampsia patients. Deranged coagulation profile was also seen a small group of pre-eclampsia and eclampsia patients but not found significant.
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There are few published data on the role of vitamin D concentrations during pregnancy in sub-Saharan Africa. Thus, the aim of the current study was to investigate the association between 25-hydroxyvitamin D (25[OH)]D) levels and pre-eclampsia.A case-control study, with 60 women in each arm, was conducted in Medani Hospital in Sudan. The cases were women with pre-eclampsia and healthy pregnant women as controls. The medical and obstetric history was obtained using a questionnaire. The serum 25(OH)D concentrations were measured using ELISA.The median (IQR) of 25(OH)D concentration was significantly lower in women with pre-eclampsia than in the controls (10.0 [6.5] vs 18.3 [22.1] ng/mL). Fifty-three cases with pre-eclampsia (88%) and 36 cases in the control group (60%) had vitamin D deficiency (25(OH)D level≤20 ng/mL). Multivariate logistic regression showed that the 25(OH)D levels were negatively associated with pre-eclampsia (adjusted OR [AOR]=0.87, 95% CI 0.81 to 0.92). Vitamin D-deficient women were at a higher risk of pre-eclampsia (AOR=4.51, 95% CI 1.70 to 11.94).Low 25(OH)D levels were reported in women with pre-eclampsia and were an independent risk factor for pre-eclampsia.
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Objective:To approach the damage of vascular endothelial cell and the actived state of platelet and the disfunction of liver and kidney of patients with pre-eclampsia and eclampsia..Methods:The levels of GPⅠbα were determined by flow cytometey (FCM),and the levels of Cr, BUN, UA, ALT, AST, TP, ALB, ALP were measured by auto biochemistry analysator. The venous blood of 32 severe pre-eclampsia or eclampsia women,16 mild pre-eclampsia women and 22 normal late pregnancy women were collected..Results:The levels of GPⅠbα, TP and ALB of the severe pre-eclampsia and eclampsia group were much lower than that of normal late pregnancy group and mild pre-eclampsia group (P0.01). The levels of Cr, BUN, UA, ALT and AST of the severe pre-eclampsia and eclampsia group were much higher than those of normal late pregnancy group and mild pre-eclampsia group(P0.01). The levels of TP and ALB and UA of mild pre-eclampsia group were lower than those of normal late pregnancy group,levels of ALP between each group had no significant deviation,level of GPⅠbα was negative correlation with levels of Cr, BUN, ALT, AST.Conclusion:Patients with pre-eclampsia and eclampsia have the damaged vascular endothelial cells and the actived platelets,and dysfunction of liver and kidney with the development of the pathogenetic condition.
Normal group
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Objective:To detected the levels of the GPⅡb/Ⅲa in the blood and PLT in the serum of the patients of pre-eclampsia and eclampsia,to discuses the role of platelet-active factors in the development of pre-eclampsia and eclampsia.Methods:GPⅡb/Ⅲa and PLT were measured in the normal non-pregnancy women,normal late-pregnancy women and pre-eclampsia and eclampsia women.The GPⅡb/Ⅲa of whole blood was detected by flow cytometry and the levels of PLT in the serum were detected by blood cell analyst.Results:The levels of GPⅡb/Ⅲa in the mild pre-eclampsia(0.49±0.16) and normal non-pregnancy(0.46±0.12) or normal late-pregnancy(0.54±0.19)in pre-delivery had no significance(P0.05).Severe pre-eclampsia/eclampsia in pregnancy(2.60±0.63) was higher than non-pregnancy,normal late-pregnancy and mild pre-eclampsia(P0.01).There was no significance between the groups in post-delivery.The GPⅡb/Ⅲa in severe pre-eclampsia/eclampsia had obvious changes in pre-delivery and post-delivery,the mild pre-eclampsia had no obvious change.The count of PLT:The mild pre-eclampsia(210.43±69.58) and normal non-pregnancy(232.16±39.47) or normal late-pregnancy(218.45±53.12)in pre-delivery had no obvious changes(P0.05),but severe pre-eclampsia/eclampsia(154.19±57.61) had obvious change(P0.05).Conclusion:It shows significant negative correlation that the higher the level of GPⅡb/Ⅲa in the blood is,the lower the count of PLT in the blood serum is.This change of co-relationship is an important marker of the diagnoses.
Clinical Significance
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BACKGROUND: Pre-eclampsia and eclampsia are the major health problem in developing countries.MgSO4 is the standard drug in the control of eclamptic convulsions. OBJECTIVE:The aim of the study is to compare the efficacy of low dose MgSO4 regime versus Zuspan's regime in control and prevention of convulsions and to compare the therapeutic levels, maternal outcome and fetal outcome.STUDY DESIGN: It was a randomized prospective study conducted at Kempegowda Institute of Medical Sciences and Hospital, Tertiary level referral hospital from January 2009 to June 2010.This Study included 60 patients who were admitted with eclampsia and severe pre-eclampsia.A Study group of 30 patients were randomized to receive low dose Magnesium Sulphate and a Control group of 30 patients received Zuspan's regime.Type of convulsions, no. of convulsions, therapeutic drug level, maternal complications and perinatal outcome are compared between study and control groups.RESULTS: Both the groups are comparable in terms of type of convulsion, No. of convulsion, therapeutic drug level, maternal complications and perinatal outcome.CONCLUSIONS: Low dose MgSO4 can be used as preventive and therapeutic measure in severe pre-eclampsia and eclampsia with equal effectiveness as Zuspan's regime.
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Objective Retrospectively analyze the data of 9 cases of eclampsia in hospital is conducted and and the measures of how to avoid and decrease the occurrence of eclampsia were discussed. Methods Nine cases were diagnosed as eclampsia in hospital from 2002 to 2009 and their clinical data were analyzed. The 9 cases were divided into 2 groups. Group A was defined as the cases diagnosed as severe pre-eclampsia before eclampsia attacked and eclampsia attacked in hospital after treatments, and 3 cases met these criteria. Group B was defined as the cases diagnosed as pre-eclampsia or hypertensive disorders complicating pregnancy before eclampsia, and 6 cases met these criteria. The eclampsia in group B attacked after labor. Results ①All cases in group A were treated in hospital with Magnesium sulfate, but none was applied with Magnesium sulfate when eclampsia attacked. The longest interval of Magnesium sulfate was 45 hours and the shortest was 6 hours. Eclampsia before labor happened in 1 case while 2 cases occurred after labor. ② The attack of Eclampsia in group B was all in the active phase. All of them had eclampsia after delivery and none of them were treated with Magnesium sulfate. The blood pressure was normal or mildly increased. The eclampsia didn't attack after effective treatment. Conclusion Magnesium sulfate is the most effective drug to prevent eclampsia. ①The pregnant women with severe pre-eclampsia should be given sufficient Magnesium sulfate before labor and during and after labor. ②For those women with normal and mild increased blood pressure, clinicians should give enough attention to the change of blood pressure and avoid undesirable stimulation, and timely apply with magnesium sulfate.
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