More patients assigned to magnesium sulfate achieved the primary outcome (87% compared with 72%, P=.01). Department of Obstetrics, Weifang People's Hospital, Weifang, China, Edited by: Songwen Tan, Central South University, China, Reviewed by: Li Zhu, Central South University, China; Jing Xu, Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, China, This article was submitted to Visceral Surgery, a section of the journal Frontiers in Surgery. Objective: To evaluate the risk of developing pulmonary edema in women exposed to nifedipine, magnesium sulfate (MgSO4), or both in a preterm setting. Comparison of clinical efficacy between the two groups (n = 55, %). A significant increase in PT indexes was observed in the research group after treatment, and the Fbg, D-D, and PLT were significantly lower than those in the control group. Medical officers assist patients to complete the relevant examinations. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The heart rate of patients will not decrease indefinitely after slowing down to a certain extent, and then tend to stabilize by themselves. According to the random number table method, 110 patients were divided into the control group and the therapy group, with 55 cases in each group. SPSS23.0 statistical software was adopted to process the data. An average age of (32.56 3.42) years was found in the control group, which ranged from 20 to 44 years old; a 24-year-old was the youngest participant in the study, followed by an average of 34 years old, and a 44-year-old was the oldest. Am J Obstet Gynecol. Before therapy, there was no significant difference in PT, TT, APTT, and Fib between the two groups (P > 0.05). All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Unfortunately, this drug is not used in our market [26]. Magnesium sulphate therapy in women with pre-eclampsia and eclampsia in Kuwait. Take the serum of the two groups of patients in 1.5.2, use the BS-800 automatic biochemical analyzer (Zhengzhou Nanbei Instrument Equipment Co.Ltd.) In patients with pregnancy-induced hypertension, the activity and content of antioxidant enzymes are found to be low, such as SOD, on the contrary, a large amount of peroxidation products are generated in the body, such as LPO and MDA. The total clinical effective rate of patients in the therapy group was 94.5%, and the total clinical effective rate of patients in the control group was 81.8%. Received 2022 Aug 3; Revised 2022 Aug 11; Accepted 2022 Aug 27. Neither group had significantly different vascular endothelial function before treatment, and the difference was not statistically significant (P > 0.05). If the knee tendon reflex was found to be significantly weakened or disappeared, or the number of breaths was <16 times/min, the patient's urine output was <25 ml/h, the medication should be stopped immediately, 7 days as a course of treatment. The patients/participants provided their written informed consent to participate in this study. The present study outlines the clinical effectiveness of nifedipine and magnesium sulfate combined with labetalol in PIH, to guide clinical decision making in the selection of a better treatment plan. Effective: (i) as a result of the treatment, the systolic blood pressure was below 140mmHg; the diastolic blood pressure was below 90mmHg, and the urine protein<0.3g/24h, 90% > N 66.67%. Nifedipine tablets can inhibit the influx of calcium ions into the cells by obstructing the membrane transport of calcium ions in the myocardium and vascular smooth muscle, which increases the coronary blood flow and improves the tolerance of the myocardium to ischemia, thereby achieving the effect of lowering blood pressure (4, 5). The reason may be that nifedipine combined with magnesium sulfate and labetalol can downregulate the expression of endothelin and improve endothelial dysfunction. Available for Android and iOS devices. Some mixtures of medications can lead to serious and even fatal consequences. From January 2019 to April 2021, 100 participants with PIH in our center were randomly assigned to a control group and a research group. Vestgaard M., sbjrnsdttir B., Ringholm L., et al. (A) was comparison of systolic blood pressure between the two groups. (B) Comparison of the incidence of clinical efficacy between the two groups. Ramzan F., Qadir S., Zarin S. G., Tahir F., Malik S. Role of labetalol in control of hypertension during pregnancy. Clinical use of nifedipine can prevent threatened preterm labor. Magnesium sulfate combined with nifedipine can better relax peripheral vascular smooth muscle, reduce vascular resistance, and improve uterine artery blood flow. A probability value of <.05 was considered statistically significant. There are 103 drugs known to interact with magnesium sulfate, along with 8 disease interactions. This site needs JavaScript to work properly. The results of this study are consistent with the above reports. Magnesium sulfate/nifedipine interaction Prolonged neuromuscular blockade: case report Reactions Weekly 1753 , 224 ( 2019) Cite this article 96 Accesses Metrics Author Information An event is serious (based on the ICH definition) when the patient outcome is: * death * life-threatening * hospitalisation * disability * congenital anomaly Compared to the control group, the research group's ET-1 was lower, and its level of NO was higher than the control group's; the difference was statistically significant (P < 0.05). Preeclampsia is defined as follows: after 20 weeks of pregnancy, expecting mothers without history of hypertension find that their blood pressure has increased (systolicbloodpressure 140mmHgand/ordiastolicbloodpressure 90mmHg), accompanied by changes in urinary protein or pathological changes in the vital organ system, or placental-fetal lesions, accounting for about 3.9% of all pregnancies [16]. After therapy, the systolic blood pressure and diastolic blood pressure of the two groups were significantly decreased, and the therapy group was significantly lower than the control group (P < 0.05). Therefore, as a global disease, PIH has attracted widespread attention because of its serious threat to maternal and infant safety. 2004 Jun;190(6):1520-6. doi: 10.1016/j.ajog.2003.12.057. Medical staff should carefully record the blood pressure control of patients, instruct patients to maintain a light diet, emphasize dietary taboos and matters needing attention in life, supervise the use of drugs, and strengthen the observation of adverse drug reactions. . Federal government websites often end in .gov or .mil. Current studies have confirmed that the erosion function of trophoblasts in early pregnancy decreases, which leads to the shallow implantation of placenta into the endometrium and triggers the occurrence of PIH. The blood pressure levels (systolic and diastolic blood pressure), coagulation indexes (TT, PT, APTT, Fib), oxidative stress indexes (LPO, MDA, SOD), vascular endothelial function (ET-1, NO), clinical efficacy and adverse reactions of the two groups were compared. Please enable it to take advantage of the complete set of features! Therefore, it is necessary to be cautious in the choice of drugs during treatment. Does magnesium sulfate interact with my other drugs? Nifedipine, in combination with magnesium sulfate and labetalol, is effective at treating PIH, reducing blood pressure, improving blood coagulation, preventing cardiovascular events and vascular endothelial function, and further improve the pregnancy outcome. The preferred drug for controlling blood pressure in HDCP is -adrenergic agonist methyldopa. There are some limitations in this study. During the treatment, side effects such as palpitation and headache may occur after taking nifedipine. Patients in the control group were given magnesium sulfate intervention treatment. The increase in serum ET-1 level and the decrease in NO concentration are one of the mechanisms of the pathogenesis of pregnancy-induced hypertension. Based on the results of the study, the effective rate totaled 92.00%, while as for the control group, it was 80.0%, which indicates that there was a statistically significant difference between the effective rates of the research group and that of the control group, and the difference was statistically significant (P < 0.05). Djokic V, Jankovic S, Labudovic-Borovic M, Rakocevic J, Stanisic J, Rajkovic J, et al.. Pregnancy-induced hypertension decreases Kv1.3 potassium channel expression and function in human umbilical vein smooth muscle. This reaction demonstrates that nifedipine can seriously potentiate the toxicity of magnesium. HDCP is a kind of disease which coexists with hypertension and pregnancy, in addition to preeclampsia and gestational hypertension, chronic hypertension related to preeclampsia, eclampsia, and chronic hypertension complicating pregnancy are also among its complications. being able to get an erection, but not having it last long enough for sex. There was a higher degree of improvement in the PIH group than in the control group, indicating that nifedipine alone or in combination with magnesium sulfate and labetalol could reduce hypercoagulability. government site. Nifedipine combined with magnesium sulfate and labetalol can dilate blood vessels and reduce blood pressure [37]. The effect of sublingual administration is faster than that of oral administration. Conclusion: Nifedipine tablets combined with magnesium sulfate in the treatment of PIH can improve the blood coagulation function of patients, reduce oxidative stress damage, adjust the serum levels of ET-1 and NO, and improve the clinical efficacy. Compared with the pregnancy outcome, in comparison to the controls, the research group had a higher vaginal delivery rate. Clinical studies have found that PIH has many effects on pregnant women, fetuses, and newborns. This reaction demonstrates that nifedipine can seriously potentiate the toxicity of magnesium. Ruano C. S. M., Apicella C., Jacques S., et al. (B) was comparison of MDA between the two groups. If there are abnormalities in this process, the erosion ability of extravillous trophoblasts is impaired; the uterine spiral artery is not eroded enough by trophoblasts, and the erosion range is reduced [20]. The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author. Incomplete clinical data. The results of this study showed that the oxidative stress level of the two groups of patients after therapy was significantly improved compared with that before treatment, and the serum LPO and MDA of the therapy group were lower than those of the control group, and the SOD level was higher than that of the control group, suggesting that nifedipine tablets combined with magnesium sulfate. Caution should be exercised when these two tocolytics are combined. Vascular smooth muscle destroys sympathetic ganglion impulse conduction, promotes vasodilation and lowers blood pressure; in addition, magnesium sulfate also has the effect of accelerating protein metabolism, anti-inflammatory and de-seeding, thereby effectively alleviating the symptoms of proteinuria and edema in patients (10). At present, it is considered that nifedipine and labetalol have good therapeutic effect onPIH. 2003 Jan 23;348(4):304-11. doi: 10.1056/NEJMoa021180. In the past ten years, the theory of placental superficial implantation, as a theory to explain HDCP, has been gradually accepted by most scholars [19]. Mahakarkar M. Treatment of pregnancy induced hypertension and its effect on oxidative stress. All generic drug interactions for nifedipine oral (lists will include brand and generic names): 23 serious drug interactions. [36]. It slows down the heart rate and lowers blood pressure at the same time [28]. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). The main clinical manifestations are urinary protein, elevated blood pressure, and limb edema, which could lead to a series of consequences, such as fetal growth retardation, placental abruption, preterm delivery, fetal death, and postpartum hemorrhage. 2019 Sep 9;19(1):651. doi: 10.1186/s12913-019-4377-6. (B) was comparison of TT between the two groups. Bethesda, MD 20894, Web Policies official website and that any information you provide is encrypted Before and after therapy, 5 ml of fasting cubital venous blood was collected from the two groups of patients in the morning during the obstetric examination, centrifuged at 3,500 r/min for 10 min to take the upper serum, and placed in the refrigerator at 80C for later use. The https:// ensures that you are connecting to the the contents by NLM or the National Institutes of Health. Patient Population: The population will include pregnant women at gestational age between 32 and 36 weeks who are 18 years old or older and have signs of threatened preterm . The level of NO increases significantly in the first trimester and decreases in the third trimester, and returns to normal after delivery, suggesting a significant increase in NO release during pregnancy (17). In the research group, a 92.00% success rate was achieved in 31 cases whose effectiveness was marked; 15 cases whose effectiveness was marked, and four cases whose effectiveness was ineffective. Due to the different physical types, receptors, and pharmacological mechanisms of medicine in pregnant women, it is not possible to determine that labetalol hydrochloride can play a better effect on each body in the group. being unable to get an erection at any time. In future research, we will carry out multicenter and large-sample prospective studies, or more valuable conclusions can be drawn. being able to get an erection sometimes, but not every time you want to have sex. In conclusion, PIH can be effectively treated with nifedipine, magnesium sulfate, and labetalol, which can effectively reduce blood pressure, improve blood coagulation and vascular endothelial function, and further improve the pregnancy outcome. The use of nifedipine and magnesium sulfate together does not increase the risk of serious magnesium-related effects. The primary outcome was arrest of preterm labor, defined as prevention of delivery for 48 hours with uterine quiescence. The increase of blood pressure after pregnancy will lead to the damage of vascular endothelium and the release of endogenous vasodilator factor, vasodilator factor, and NO. After admission, all patients were given routine diet education guidance, close monitoring of blood pressure. Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum. Do not stop using any medications without first talking to your doctor. Accessibility The information provided here is for informational purposes only. The results of this study showed that after therapy, serum TT, PT and APTT levels were higher in the treatment group than in the control group, and Fib levels were lower than in the control group. All patients underwent routine fundus examination, blood coagulation function examination, biochemical index examinations such as heart, liver, kidney function, blood electrolytes, fetal growth and development index examination, cardiac ultrasonography, liver, gallbladder, spleen and kidney ultrasound examination to rule out important organ diseases. Lyndon A., Baer R. J., Gay C. L., el Ayadi A. M., Lee H. C., Jelliffe-Pawlowski L. A population-based study to identify the prevalence and correlates of the dual burden of severe maternal morbidity and preterm birth in California. Usually avoid combinations; use it only under special circumstances. You should avoid or limit the consumption of grapefruit and grapefruit juice if you are receiving treatment with NIFEdipine. In normal pregnancy, ET-1 is at a normal level, and its increase will cause systemic arteriole spasm, promote the secretion of aldosterone and angiotensin, increase peripheral vascular resistance, and increase blood pressure. Pregnancy hypertension refers to a state in which both increased blood pressure and pregnancy coexist. Magnesium Sulfate-Sodium Chloride injection uses and side effects, Email this report to a friend, doctor, or patient. Drug regimen for patients in the control group: magnesium sulfate injection (Anyang Kyushu Pharmaceutical Co., Ltd., national drug standard H41023035, specification: 10ml:2.5g), 20ml was mixed with 100m1 5% glucose injection (Jiangsu Shenlong Pharmaceutical Co., Ltd., national medicine standard word H32024365, specification: 100ml/bag), intravenous drip for 0.5h, and then 60ml magnesium sulfate injection combined with 1000m1 5% glucose injection was mixed with intravenous drip for maintenance treatment. Effective: after therapy, the patient's systolic blood pressure is 140 and 150 mmHg, and the diastolic blood pressure is 90 and 100 mmHg. While the placenta is not affected by drugs, which can have a satisfactory effect on the perinatal final maternal and infant outcome [8, 9]. Therefore, care must be taken in the choice of drugs during the treatment process. The purpose is to investigate the influence of nifedipine, labetalol, and magnesium sulfate on blood pressure control, blood coagulation, and maternal and infant outcome in those suffering from pregnancy-induced hypertension (PIH). Add your drug list to My Med List to view medical information in a simple, easy-to-read, personalized format. Affinati A. H., Auchus R. J. Endocrine causes of hypertension in pregnancy. Nifedipine is a dihydropyridine calcium channel blocker, which can dilate vascular smooth muscle and improve peripheral vasospasm. Jafar M. A., Rauf S., Daud D. Profile of minimal and non-minimal change nephrotic syndrome in children: a cross-sectional study. Comparison of blood pressure between the two groups. A total of 110 patients with hypertension during pregnancy were admitted to our hospital from January 2020 to January 2021. 8600 Rockville Pike Enaruna N. O. VP50.25: Predicting pregnancy and long-term risk of hypertension with uterine artery Doppler and flow-mediated dilation of the brachial artery in Nigerian women. sharing sensitive information, make sure youre on a federal Cases of pulmonary edema were age, and gestational age matched to controls at a ratio of 1 case to 4 controls. After treatment, the ET-1 of the two groups decreased, and the level of NO increased. Comparison of pregnancy outcomes between the two groups. It was suggested that the combination of nifedipine tablets and magnesium sulfate was effective in improving hypercoagulability in patients with pregnancy-induced hypertension, and was more effective than magnesium sulfate alone. 2019 Apr 10;7:2050312119843700. doi: 10.1177/2050312119843700. The measurement data were presented as (xs). After that, 60 ml (5 g) of magnesium sulfate was used daily. Comparison of the Effects of Nifedipine and Magnesium Sulfate on Maternal and Fetal Doppler Blood Flow Patterns in Women With Preterm Labor: Actual Study Start Date : September 1, 2022: Estimated Primary Completion Date : December 31, 2022: Estimated Study Completion Date : March 31, 2023: sharing sensitive information, make sure youre on a federal The antihypertensive effect appeared after 10 minutes of spray administration; the effect was the most significant after 1 hour, and the blood pressure increased after about 3 hours (some can last for 11 hours). For the following two weeks of treatment, both groups were evaluated for clinical efficacy. Those who were allergic to the drugs used in this study. INTRODUCTION. Patients in active preterm labor who were at 24 to 33 weeks and 6 days of gestation were randomly assigned to receive magnesium sulfate or nifedipine. Toxemia of Pregnancy. Ghosh K. R., Akhter S., Das A. K., Naher N., Paul S. R., Islam B. FOIA Nifedipine is a calcium antagonist, which can relax vascular smooth muscle, expand blood vessels, reduce peripheral vascular resistance, lower blood pressure, and it can reduce afterload, suitable for long-term use, and can make up for the defects of magnesium sulfate (11). Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. The main drugs of PIH treatment commonly used in clinic are magnesium sulfate, which has the effects of sedation, spasmolysis, and antihypertensive. eCollection 2019. All the data results are shown in Figure 2. UNABLE TO DISPLAY ANY INTERACTIONS AT THIS TIME. Automatically receive FDA alerts, drug interaction warnings, plus data on food, allergy & condition interactions. J Med Assoc Thai. Erectile dysfunction (ED) is often a symptom . National Library of Medicine Department of Obstetrics and Gynecology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, China. Saavedra H., Toncel C., Delgado V., Borr O., Rojas-Surez J. Reversible pulmonary hypertension and high-output heart failure triggered by pregnancy in a patient with congenital arteriovenous malformation: a case report. Significantly, in the research group, both systolic and diastolic blood pressures were higher than those in the control group, with the difference being statistically significant, and the difference was statistically significant (P < 0.05). It is often recommended for patients with moderate and severe PIH. 22: intravenous labetalol versus oral nifedipine for acute hypertension in pregnancy: effects on cerebral perfusion pressure. No use, distribution or reproduction is permitted which does not comply with these terms. HHS Vulnerability Disclosure, Help Objective: Allen N. B., Khan S. S. 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And pregnancy coexist can downregulate the expression of endothelin and improve uterine artery flow... Or patient relax peripheral vascular smooth muscle and improve peripheral vasospasm of NO.! Considered that nifedipine can better relax peripheral vascular smooth muscle and improve peripheral vasospasm the U.S. of!