剖宫产子痫前期患者术前准备:拉贝他洛尔与硝苯地平控制血压升高效果的前瞻性随机对照研究

D. Khalifa, A. Mohamed, M. Elsersi
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摘要

背景:先兆子痫是一种广泛的血管内皮功能障碍和血管痉挛,发生在妊娠20周后。研究目的:比较口服拉贝他洛尔和口服硝苯地平治疗轻度子痫前期的降压效果。患者和方法:本研究在艾因沙姆斯大学妇产医院重症监护室和产科医院共100例产前轻度足月子痫前期妇女中进行。随机分为两组:第一组(A组):口服拉贝他洛尔起始剂量为200mg;第二组(B组):口服硝苯地平起始剂量为20mg。结果:B组患者不良反应发生率明显高于a组,无HELLP综合征、肺水肿、凝血功能障碍、产后虚瘫等严重并发症发生,产妇死亡率为零。因此,当先兆子痫患者在早期阶段被识别和治疗时,与先兆子痫相关的发病率和死亡率可以显著降低。结论:口服拉贝他洛尔与口服硝苯地平对轻度子痫前期高血压的控制效果相同。在药物副作用和耐受性方面,拉贝他洛尔明显优于。硝苯地平。两组新生儿结局无显著差异。因此,拉贝他洛尔是硝苯地平更好的替代品,因为它的副作用更小。但在资源有限的情况下,硝苯地平是一种同样有效、便宜且容易获得的药物,用于治疗轻度子痫前期。
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Pre-operative Preparation of Pre-eclamptic Patients Undergoing Cesarean Section: A prospective randomized comparative study between the effect of Labetalol versus Nifedipine in controlling elevation of blood pressure
Background: Pre-eclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks' gestation.Aim of the Work: comparing the anti-hypertensive efficacy of oral Labetalol with oral Nifedipine in mild preeclampsia .Patients and Methods: This study was conducted on a total of 100 antenatal mild full term preeclamptic women at Ain Shams University maternity hospital ICU and obstetric theater. They were divided into two groups: First group (group A): Oral Labetalol was started with a dose of 200 mg and Second group (group B): Oral Nifedipine was started at dose of 20 mg. Results: group B had significantly higher number of side effects when compared to group A. None of the patients developed grave complications such as HELLP syndrome, pulmonary edema, coagulopathy, postpartum collapse, the maternal mortality was nil. Thus when patients with preeclampsia are identified and treated at an earlier stage the morbidity and mortality associated with preeclampsia can be significantly reduced.Conclusion: Both Oral Labetalol and oral Nifedipine are equally efficacious in the control of hypertension in mild preeclampsia. Regarding the drug side effects and tolerability, Labetalol was significantly better than. Nifedipine. There was no significant difference in the neonatal outcome between the two groups. Thus Labetalol is a better alternative to Nifedipine, as it had lesser side effect profile. But in a limited resource setting, Nifedipine is an equally effective, cheap and easily available drug for mild preeclampsia.
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