Introduction: In the Philippines, hypertensive diseases of pregnancy belong in the top three causes of maternal mortality and complicate up to 10% of pregnancy worldwide. In relation with this, proper interventions must be given during the prenatal check-up to prevent occurrence that may cause feto-maternal mortality and morbidity. During prenatal check-up, pregnant women are given vitamin and mineral supplementations. Vitamin D has an association of having a risk for preeclampsia. Receptors of Vitamin D and 1-a hydroxylase are both expressed in the decidua and trophoblast cells. The active form of Vitamin D affects the transcription and function of genes associated with angiogenesis, invasion of the placenta, and normal implantation. The mechanisms mentioned are all involved in the pathophysiology of preeclampsia. Objectives: The primary outcome of this study is to determine the association of Vitamin D supplementation in preeclampsia. Specifically, this study aims to compare the following secondary outcomes: Maternal outcomes (complication of gestational diabetes mellitus and underwent cesarean delivery) and fetal outcomes (preterm delivery and birth weight). Methodology: Meta-analysis and systematic review of eight randomized controlled trials. Results: Vitamin D reduced the risk of preeclampsia (risk ratio [RR] 0.45, 95% confidence interval [CI] 0.30–0.69; P = 0.0002). No significant difference on risk of gestational diabetes mellitus (RR 0.84, 95% CI 0.48–1.48) and risk of preterm delivery (RR 0.71, 95% CI 0.49–1.03). Results showed that newborns of mothers who had no Vitamin D supplementation had a higher birthweight (P = 0.010). No significant difference on cesarean section rate (RR 1.12, 95% CI 0.87–1.45). Conclusion Evidence suggests that Vitamin D supplementation can reduce the risk of preeclampsia. This study encourages obstetricians in our country to add Vitamin D supplementation as prenatal medication to prevent preeclampsia, thereby reducing maternal morbidity and mortality.
Preeclampsia ; Vitamin D

Background: Preeclampsia is a major cause of maternal and perinatal mortality and morbidity, affecting 5 - 6% of all pregnancies. Recently, homocysteine (Hcy), a metabolite of amino acid methionine has been postulated producing oxidative stress, endothelial cell dysfunction, and alterations associated with preeclampsia. It is unclear whether high concentration of circulating Hcy causes preeclampsia, or whether this is a secondary phenomenon of metabolic alterations resulting from the disorder. Objectives: (1) Determining blood Hcy concentration in pregnancies in various severities of preeclampsia. (2) Discover the relationships between serum Hcy and other biological markers in preeclampsia. Subjects and method: This descriptive cross-sectional study consisted of 3 groups of pregnancies admitted to Thanh Nhan Hospital: 24 normal pregnant women, 28 pregnancies with non-serious preeclampsia, and 27 pregnancies with serious preeclampsia. Concentrations of blood Hcy of all participants were assayed by a competition fluorescence immunoassay (FPIA). Results: The mean concentration of serum Hcy during normal pregnancy was 5.2+/-1.0micromol/L compared with 7.1+/-1.8micromol/L among pregnancies with non-serious preeclampsia, and 11.7+/-2.9micromol/L among pregnancies with serious preeclampsia. Serum Hcy increased in pregnancies with renal dysfunction, elevated serum uric acid, and injuries of liver cells. Conclusion: Concentration of the serum Hcy in pregnancies with serious preeclampsia is significantly higher than that of pregnancies with non-serious preeclampsia, and the serum Hcy in pregnancies with non-serious preeclampsia is significantly higher than that of normal pregnancies. There are relationships between elevated serum Hcy in preeclampsia with level of kidney failure, injury of liver and increased levels of serum uric acid.
Homocysteine ; Preeclampsia

Objective: To determine whether giving of magnesium sulfate to patients with mild preeclampsia is beneficial. Design: Retrospective cohort study. Setting: Tertiary-care training hospital. Participants: Patients admitted from January 2001-June 2005 with BP > 140/90 and with a +1 albuminuria by dipstick method. Patients were grouped into three arms: those who received complete magnesium sulfate doses (14 grams loading dose + 20 grams succeeding doses), those who received loading dose of magnesium sulfate only (14 grams), and those without treatment. Interventions: Review of charts. Main outcome measure: The primary outcome was the occurrence of eclampsia and magnesium toxicity. Results: There were 123 patients fiagnosed with mild preeclampsia from January 2001 to June 2005. Ninety four charts (76.42 percent) were retrieved and reviewed. Of the 94 reviewed, 21 (22 percent) did not receive magnesium sulfate, 23 (24 percent) received the loading dose of magnesium sulfate only, and 50 (53 percent) received the complete doses of magnesium sulfate. There were no statistically significant differences in the occurrence of eclampsia among the three groups, as well as the occurrence of magnesium toxicity among the treated groups; however, the numbers were small. Conclusion: All patients included in the study did not develop eclampsia, and those patients who received magnesium sulfate, whether loading dose only or complete doses, did not develop magnesium toxicity. (Author)
Magnesium Sulfate ; Preeclampsia ; Eclampsia ; Malbuminuria