Effect of magnesium sulfate combined with labetalol on serum sFlt‑1/PlGF ratio in patients with early‑onset severe pre‑eclampsia

Abstract

The aim of the present study was to investigate the therapeutic effect of magnesium sulfate combined with labetalol on the early-onset severe pre-eclampsia (ES-PE) and explore the role of soluble fms-like tyrosine kinase-1 (sFlT-1), placental growth factor (PlGF), and sFlt-1/PlGF ratio in the treatment. A total of 164 ES-PE patients admitted to the Maternity and Child Health Care Hospital of Hubei (Wuhan, China) were assigned to this observational study. Among them, 83 patients were enrolled in group A and treated with magnesium sulfate combined with labetalol hydrochloride, and 81 patients were enrolled in group B and treated with magnesium sulfate. The therapeutic effect, adverse reactions and pregnancy outcomes in the two groups were analyzed. Serum sFlt-1 and PlGF concentrations, before and after treatment, were measured by enzyme-linked immunosorbent assay (ELISA). Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive value of pre-treatment serum sFlt-1/PlGF ratio for the clinical outcome. The effective rate was significantly higher in group A than that in group B. Group A presented superior pregnancy outcomes over group B. The serum sFlt-1 concentration and sFlt-1/PlGF ratio after treatment were significantly lower than those before treatment in groups A and B, whereas PlGF concentration was significantly higher after treatment in both groups. After treatment, group A had markedly lower serum sFlt-1 concentration and sFlt-1/PlGF ratio than group B, and markedly higher PlGF concentration than group B. The area under curve (AUC) of serum sFlt-1/PlGF ratio before treatment for the prediction of the clinical efficacy was 0.737. In conclusion, magnesium sulfate combined with labetalol could be effectively used for the treatment of ES-PE. The results of ELISA revealed that the balance of sFlT-1 and PlGF was improved after treatment and the sFlT-1/PlGF ratio was decreased. The assessment of sFlt-1/PlGF ratio before treatment was shown to have a certain predictive value for the efficacy of ES-PE treatment.

Comparison of outcomes following intravenous magnesium compared with intravenous labetalol and oral nifedipine in 355 pregnant Han Chinese women with preeclampsia

“…The primitive reduction in blood pressure in the MS cohort suggests that magnesium sulfate is not the primary hypertensive agent and antihypertensive effect is due to a reduction in the action of circulating calcium-dependent vasoconstrictors. [12] The results of primitive reduction in blood pressure due to intravenous magnesium sulfate in the current study are consistent with those of the retrospective study of Thai women [12] and an observational study [19] but are not consistent with those of the prospective descriptive study. [17] Genetic polymorphisms are responsible for the different responses of individuals to antihypertensive drugs.…”

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

“…erefore, early detection and early treatment are very important to improve outcomes in mother and infant. Magnesium sulfate is the drug of choice for the treatment of SPE, which has the effect of relieving spasm of vascular smooth muscle, inhibiting central and motor nerves and the release of acetylcholine, reducing muscle contraction, dilating vascular smooth muscle, expanding spasm of peripheral blood vessels, and reducing blood pressure [16]. However, the clinical effect of single use is not good because severe placental ischemia and hypoxia will lead to maternal endothelial dysfunction [17].…”