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比较分析在治疗子痫前期和子痫中抗高血压和抗惊厥治疗方案:来自苏丹回顾性研究的见解。

Comparative Analysis of Antihypertensive and Anticonvulsant Regimens in Managing Pre-eclampsia and Eclampsia: Insights from a Sudanese Retrospective Study.

机构信息

Department of Pharmacology, Faculty of Pharmacy, Alneelain University, Khartoum, Sudan.

Department of Pharmacology, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan.

出版信息

Med Sci Monit. 2024 Jul 22;30:e944985. doi: 10.12659/MSM.944985.

Abstract

BACKGROUND Preeclampsia presents with gestational proteinuria, usually after 20 weeks of gestation, and can be complicated by generalized tonic-clonic seizures of eclampsia. Particularly in countries with limited healthcare resources, preeclampsia and eclampsia are major causes of maternal morbidity and mortality. This retrospective study aimed to evaluate the presentation, management, and outcomes of 185 women with preeclampsia and eclampsia in 2 maternity hospitals in Omdurman, Sudan, between January and December 2020. MATERIAL AND METHODS An analytical retrospective study was conducted in 2 main maternity hospitals in Omdurman, Sudan, between January and December 2020. The study included 185 pregnant women with preeclampsia or eclampsia. Data on clinical and obstetric characteristics (history of the illness, comorbid diseases, parity, gravida, multifetal pregnancy, and laboratory investigations), medications used, and maternal and neonatal outcomes were obtained for the diagnosis. The data were analyzed using the SPSS version 27. RESULTS Results: The mean age was 27.2±6.3 years, with 42.7% primigravida, 30% had a triple-drug regimen, nifedipine was the most common antihypertensive (60.5%), and 17.3% of patients underwent observation only. The seizure rate was 20%, with 92.73% controlled with magnesium sulfate. The antihypertensive regimen before delivery was significantly associated with the mode of delivery (P=0.001) and maternal outcomes (P=0.047); the regimen used after delivery significantly achieved blood pressure control (P=0.043) and improved maternal outcomes (P=0.007), but not fetal outcomes. CONCLUSIONS Maternal outcomes were markedly affected by the antihypertensive drug regimens used and the patient's seizure control status, and use of anti-convulsants successfully controlled all seizures.

摘要

背景

子痫前期表现为妊娠蛋白尿,通常发生在妊娠 20 周后,可能伴有子痫的全身性强直阵挛性发作。特别是在医疗资源有限的国家,子痫前期和子痫是孕产妇发病率和死亡率的主要原因。本回顾性研究旨在评估 2020 年 1 月至 12 月在苏丹奥姆杜尔曼的 2 家妇产医院的 185 例子痫前期和子痫患者的表现、处理和结局。

材料和方法

在苏丹奥姆杜尔曼的 2 家主要妇产医院进行了一项分析性回顾性研究,时间为 2020 年 1 月至 12 月。研究包括 185 例子痫前期或子痫患者。对用于诊断的临床和产科特征(病史、合并症、产次、孕次、多胎妊娠和实验室检查)、所用药物和母婴结局的数据进行了收集。使用 SPSS 版本 27 对数据进行了分析。

结果

平均年龄为 27.2±6.3 岁,初产妇占 42.7%,30%使用三药方案,硝苯地平是最常用的降压药(60.5%),17.3%的患者仅接受观察。抽搐发生率为 20%,硫酸镁控制了 92.73%的抽搐。分娩前的降压方案与分娩方式(P=0.001)和母婴结局(P=0.047)显著相关;分娩后的方案显著控制了血压(P=0.043)并改善了母婴结局(P=0.007),但对胎儿结局没有影响。

结论

降压药物方案的使用和患者的抽搐控制情况显著影响母婴结局,抗惊厥药物的使用成功控制了所有抽搐。

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Preeclampsia - Current Management and Future Approach.子痫前期——当前的管理与未来的应对方法
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