OBJECTIVETo observe the effects of Xiaobai Decoction (XBD) in reducing albuminuria and shortening the duration of albuminuria in patients with pregnancy-induced hypertension syndrome (PIH) in puerperium.

METHODSEighty-five patients were given the conventional treatment with magnesium sulfate for relieving convulsion and lowering hypertension, at the same time, the treated group was given XBD additionally with the modification according to the symptoms. The treatment course for both groups was 14 days. Routine test of midstream urine was performed every three days, and 24 h-urinary protein was measured every week.

RESULTSThe therapeutic effect on the 43 patients of the treated group was markedly effective in 11 (25.6 % ), effective in 26 (60.4%) and ineffective in 6 cases (14.0%), the total effective rate being 86.0%; while in the 42 patients of the control group, the corresponding numbers were 5 (11.9%), 21 (50.0%), 16 (38.1%) and 61.9%, respectively, the efficacy of the former was significantly better (P < 0.05).

CONCLUSIONXBD is a simple, safe and effective drug for reducing albuminuria and shortening the duration of albuminuria in puerperium of PIH patients.

Adult ; Albuminuria ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension, Pregnancy-Induced ; drug therapy ; Phytotherapy ; Postpartum Period ; Pregnancy ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the TCM therapy for puerperal albuminuria (PA) in patients with gestational hypertension syndrome (GHS).

METHODSSeventy-two GHS patients with PA in the severe preeclampsia stage were assigned to the treated group (38 cases) and the control group (34 cases). They were treated, starting from the postpartum second day, with Nifedipine 10 mg three times per day, but to the treated group, Shenkangbao (SKB, a TCM patent drug for stasis resolving and dinresis) was given additionally at the dose of 10 g twice a day, 3 weeks as one therapeutic course for all. Changes of urinary albumin quality and quantity, plasma total protein and albumin, as well as renal function and blood pressure before and after treatment were observed.

RESULTSSignificant difference after treatment between the two groups was shown in terms of percentage of cases with positive albuminuria (0.7 +/- 0.8 vs. 1.5 +/- 0.9), 24-h urinary albumin (520 +/- 480 mg vs. 1352 +/- 861 mg), plasma total protein (74.5 +/- 6.3 g/L vs. 67.8 +/- 6.2 g/L), and plasma albumin (39.4 +/- 4.5 g/L vs. 34.6 +/- 4.3 g/L, all P < 0.01); also in urinary albumin negative inversion rate (92.1% vs. 67.6%, P < 0.01). No significant difference of renal function between groups, and between pre- and post-treatment was found (P > 0.05), as for the blood pressure, it showed a significant difference between pre- and post-treatment in both groups (P < 0.01), but with no difference between groups (P > 0.05).

CONCLUSIONTCM therapy for stasis-resolving and diuresis with SKB can promote the eliminating of albuminuria in puerpera in the severe preeclampsia stage.

Adult ; Albuminuria ; drug therapy ; etiology ; Diagnosis, Differential ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Hypertension, Pregnancy-Induced ; drug therapy ; Medicine, Chinese Traditional ; methods ; Nifedipine ; therapeutic use ; Phytotherapy ; Postpartum Period ; Pre-Eclampsia ; drug therapy ; Pregnancy ; Young Adult

AIMTo investigate the protective effect of low molecular weight heparin (LMWH) on nephropathy in rats with pregnancy induced hypertension and to study its possible mechanism.

METHODSThe levels of the expression of renal ERK1/2 protein and mRNA were detected in PIH rats which were made by injection of L-NAME, normal pregnant rats and rats treated with LMWH by immunohistochemistry, Western blotting and reverse transcription-polymerase chain reaction(RT-PCR). The renal tissue was observed by using light microscopy.

RESULTSThe expression level of renal ERK1/2 protein and mRNA in LMWH-treated rats were significantly lower than that in PIH rats, while the expression level of renal ERK1/2 protein and mRNA in PIH rats was significantly higher than that in normal pregnant rats (P < 0.01), the intensity of ERK1/2 expression had no obvious differences among 3 groups. The average arterial pressure and urine protein in LMWH group were decreased, but no decrease was observed in normal rats. Mesangial expansion and basal membrane thickening were obviously retarded in LMWH- treated group.

CONCLUSIONLMWH has renal protective effect on PIH rats, whose mechanism may be associated partly with a down-regulation of ERK expression.

Animals ; Female ; Heparin, Low-Molecular-Weight ; therapeutic use ; Hypertension, Pregnancy-Induced ; drug therapy ; pathology ; Kidney ; pathology ; Kidney Diseases ; etiology ; prevention & control ; Pregnancy ; Rats ; Rats, Wistar

OBJECTIVETo investigate the therapeutic effect of L-arginine (L-Arg) administration on fetus growth retardation (FGR) due to pregnancy-induced hypertension and explore its mechanism.

METHODSSixty-eight pregnant women with pregnancy-induced hypertension and FGR were enrolled in this study, and 25 of them were given L-Arg in addition to routine therapy. Umbilical artery flow parameters and serum NO concentrations in maternal and umbilical blood were measured, and the therapeutic effects were evaluated according to neonatal birth weight.

RESULTSL-Arg therapy markedly decreased the systolic/diastolic value, pulse index and resistant index (P=0.000,0), while increased the fast blood velocity rate(P=0.000,0). NO contents in maternal and umbilical blood were 60.45-/+22.68 and 28.45-/+11.35 micromol/L in L-Arg group, respectively, significantly higher than those in routine treatment group (P=0.000,0 and 0.001,7, respectively) but lower than those in the control group (P=0.000,8 and 0.000,0, respectively). The neonatal birth weights were 2.9-/+0.3 kg in L-Arg group, significantly higher than that in routine treatment group (2.7-/+0.3 kg, P=0.006,8) and similar with that of the control group (3012.9-/+295.9 g, P=0.176,2).

CONCLUSIONL-Arg promote intrauterine growth of the fetus by increasing NO production and improving the umbilical artery flow in pregnant women with pregnancy-induced hypertension and FGR.

Adult ; Arginine ; therapeutic use ; Blood Flow Velocity ; drug effects ; Female ; Fetal Growth Retardation ; physiopathology ; prevention & control ; Humans ; Hypertension, Pregnancy-Induced ; blood ; drug therapy ; physiopathology ; Nitric Oxide ; blood ; Pregnancy ; Umbilical Arteries ; physiopathology

OBJECTIVE: Psychotropic drugs use in pregnant mothers with psychiatric disorders raises issues of safety not only with the mothers but also with fetal development and the postpartum prognosis of the neonate. Several studies have reported on the harmful effects of antenatal exposure to psychotropic drugs. However, debatable disregard of the psychiatric disorder itself and issues of necessary and useful pharmacotherapy clouds the results. Hence, the purpose of this study was to retrospectively examine the association between prenatal psychotropic exposure and clinically evident fetal adverse effects. METHODS: From January 1994 to December 2011, a retrospective chart review of patients diagnosed with a major psychiatric disorder from the department of psychiatry and who also had a history of giving birth at the department of obstetrics and gynecology at Ajou University Hospital was conducted. Participants were divided into two groups: those taking psychotropic drugs during pregnancy were designated to the case group and the control group consisted of those not on psychotropics during pregnancy. Psychotropics included antidepressants, antipsychotics and benzodiazepines used in clinical dosages. Then the two groups were compared on factors such as gestational age, the offspring's birth weight, bitemporal diameter, and Apgar scores. After then, we analyzed relatively risk potential to the preterm labor in such variables (old age pregnancy, gestational diabetes, gestational hypertension and exposure psychotropics in pregnancy). T-test and logistic regression analysis of the data was performed. RESULTS: Demographic and clinical characteristics did not differ significantly between the groups. Also, there was no significant difference in gestational age, birth weight, bitemporal diameter and Apgar scores between the exposure and non-exposure groups. There was no significant relationship between psychotropic exposure during pregnancy, old age pregnancy, gestational diabetes and preterm labor. However, the relationship between gestational hypertension and preterm labor was significant. CONCLUSION: Psychotropic drugs are considered as significant clinical treatment options to control symptoms of psychiatric disorders during pregnancy. In the clinical setting there was no statistically significant relationship between psychotropic exposure and gestational age on fetal development. However the retrospective nature of the study limits the interpretation of the data and constant close monitoring of pregnant patients in the clinical setting is advised.
Antidepressive Agents ; Antipsychotic Agents ; Benzodiazepines ; Birth Weight ; Diabetes, Gestational ; Drug Therapy ; Female ; Fetal Development ; Fetus* ; Gestational Age ; Gynecology ; Humans ; Hypertension, Pregnancy-Induced ; Infant, Newborn ; Logistic Models ; Mothers ; Obstetric Labor, Premature* ; Obstetrics ; Parturition ; Postpartum Period ; Pregnancy ; Prognosis ; Psychotropic Drugs ; Retrospective Studies

OBJECTIVES: To investigate the efficacy of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection in the treatment of retinopathy of prematurity (ROP) and the risk factors for recurrence. METHODS: A retrospective analysis was performed on the medical data of 159 infants with ROP who were born in the First Affiliated Hospital of Zhengzhou University and underwent anti-VEGF treatment from January 2016 to December 2021. According to the presence or absence of recurrence within the follow-up period after initial anti-VEGF treatment, they were divided into a recurrence group with 24 infants and a non-recurrence group with 135 infants. The medical data were compared between the two groups, and a multivariate logistic regression analysis was used to investigate the risk factors for the recurrence of ROP after anti-VEGF treatment. RESULTS: After one-time anti-VEGF treatment, all 159 infants showed regression of plus disease. Recurrence was observed in 24 infants (15.1%) after anti-VEGF treatment, with a mean interval of (8.4±2.6) weeks from treatment to recurrence. The multivariate logistic regression analysis showed that preoperative fundus hemorrhage and prolonged total oxygen supply time were risk factors for the recurrence of ROP (P<0.05), while gestational hypertension was a protective factor (P<0.05). CONCLUSIONS Intravitreal anti-VEGF injection is effective for ROP. Preoperative fundus hemorrhage and long duration of oxygen therapy may increase the risk of ROP recurrence, and further studies are needed to investigate the influence of gestational hypertension on the recurrence of ROP.
Female ; Humans ; Infant ; Infant, Newborn ; Pregnancy ; Angiogenesis Inhibitors/therapeutic use* ; Endothelial Growth Factors/therapeutic use* ; Hemorrhage ; Hypertension, Pregnancy-Induced ; Oxygen/therapeutic use* ; Retinopathy of Prematurity/drug therapy* ; Retrospective Studies ; Risk Factors ; Vascular Endothelial Growth Factor A

This study aims to investigate the effect and mechanism of arctigenin(ARC) in the treatment of vascular endothelial injury in rats with pregnancy-induced hypertension(PIH). Fifty SD rats pregnant for 12 days were randomly assigned into a control group, a model group, an ARC group, a rapamycin(RAP, autophagy inducer) group, and an ARC+3-methyladenine(3-MA, autophagy inhibitor) group, with 10 rats in each group. The rats in the other groups except the control group were intraperitoneally injected with nitrosyl-L-arginine methyl ester(50 mg·kg~(-1)·d~(-1)) to establish the PIH model on the 13th day of pregnancy. On the 15th day of pregnancy, the rats in ARC, RAP, and ARC+3-MA groups were intraperitoneally injected with ARC(50 mg·kg~(-1)·d~(-1)), RAP(1 mg·kg~(-1)·d~(-1)), and 3-MA(15 mg·kg~(-1)·d~(-1))+ARC(50 mg·kg~(-1)·d~(-1)), respectively. The pregnant rats in the control group and the model group were intraperitoneally injected with the same amount of normal saline. The blood pressure and 24 h urine protein(24 h-UP) of pregnant rats in each group were measured before and after intervention. Cesarean section was performed to terminate pregnancy on day 21, and the body weight and body length of fetal rats were compared among groups. Hematoxylin-eosin(HE) staining was employed to observe the pathological changes of placenta. The expression of endothelin-1(ET-1) and endothelial nitric oxide synthase(eNOS) in placenta was detected by immunohistochemistry. The serum levels of ET-1 and nitric oxide(NO) were determined with corresponding kits. The expression of microtubule-associated protein 1 light chain 3(LC3), Beclin-1, NOD-like receptor protein 3(NLRP3), apoptosis-associated speck-like protein with CARD domain(ASC), caspase-1, interleukin(IL)-1β, and IL-18 was determined by immunofluorescence and Western blot. The level of reactive oxygen species(ROS) in placenta was measured by fluorescence staining. The results showed that on day 12 of pregnancy, the blood pressure and 24 h-UP had no significant differences among groups. On days 15, 19, and 21, the blood pressure and 24 h-UP in the model group were higher than those in the control group(P<0.05). On days 19 and 21, the blood pressure and 24 h-UP in ARC group and RAP group were lower than those in the model group(P<0.05), and they were higher in the ARC+3-MA group than in the ARC group(P<0.05). On day 21, the model group had lower body weight and body length of fetal rats(P<0.05), higher serum level of ET-1, and lower serum level of NO(P<0.05) than the control group. Moreover, the placental tissue showed typical pathological damage, down-regulated expression of LC3-Ⅱ/LC3-Ⅰ, Beclin-1 and eNOS(P<0.05), up-regulated expression of ET-1, NLRP3, ASC, caspase-1, IL-1β, and IL-18(P<0.05), and elevated ROS level. Compared with the model group, ARC and RAP groups showed increased body weight and body length of fetal rats(P<0.05), lowered serum level of ET-1, elevated serum level of NO(P<0.05), reduced pathological damage of placental tissue, up-regulated expression of LC3-Ⅱ/LC3-Ⅰ, Beclin-1, and eNOS(P<0.05), down-regulated expression of ET-1, NLRP3, ASC, caspase-1, IL-1β, and IL-18(P<0.05), and lowered ROS level. Compared with ARC group, 3-MA reversed the effects of ARC on the above indicators. In conclusion, ARC can inhibit the activation of NLRP3 inflammasome and mitigate vascular endothelial damage in PIH rats by inducing autophagy of vascular endothelial cells.
Female ; Pregnancy ; Animals ; Rats ; Humans ; Rats, Sprague-Dawley ; Hypertension, Pregnancy-Induced/drug therapy* ; Endothelial Cells ; Inflammasomes ; Interleukin-18 ; NLR Family, Pyrin Domain-Containing 3 Protein/genetics* ; Beclin-1 ; Cesarean Section ; Reactive Oxygen Species ; Placenta ; Caspase 1 ; Autophagy

OBJECTIVETo investigate the therapeutic effects of hemin, an inducer of heme oxygenase, in a rat model of gestational hypertension and explore the possible mechanism.

METHODSEighteen pregnant SD rats at day 12 of gestation were randomized equally into gestational hypertension model group, hemin treatment group, and normal pregnancy (control) group. In the former two groups, the rats were subjected to daily nitro-L-arginine methyl ester (L-NAME, 80 mg/kg) gavage since gestational day 14 for 7 consecutive days to induce gestational hypertension; saline was administered in the same manner in the control rats. The rats in hemin group received daily intraperitoneal injection of hemin (30 mg/kg) starting from gestational day 16. HO activity and carboxyhemoglobin (COHb) level in rat placental tissue were detected with spectrophotometric method, and soluble vascular endothelial growth factor receptor-1 (sFlt-1) and vascular endothelial growth factor (VEGF) level in the placental tissue homogenate supernatant were detected using ELSIA.

RESULTSAt gestational day 20, the blood pressure and 24-h urinary protein were significantly higher in the model group than in the other two groups (P<0.05), and were higher in hemin group than in the control group (P<0.05); HO activity and COHb content in the placenta tissue were the lowest in the model group (P<0.05), and was lower in hemin group than in the control group (P<0.05). The level of sFlt-1 was significantly higher and VEGF level significantly lower in the model group than in the other two groups (P<0.05); sFlt-1 level remained higher and VEGF lower in hemin group than in the control group (P<0.05).

CONCLUSIONHemin can reduce blood pressure and urinary protein in rats with gestational hypertension possibly by up-regulating HO activity, enhancing carbon monoxide production, reducing sFlt-1 and increasing VEGF in the placental tissue.

Animals ; Blood Pressure ; Carbon Monoxide ; metabolism ; Disease Models, Animal ; Female ; Heme Oxygenase (Decyclizing) ; Hemin ; pharmacology ; Hypertension, Pregnancy-Induced ; drug therapy ; Placenta ; drug effects ; metabolism ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor Receptor-1 ; metabolism