Patogenesis-based effect of magnesium - sulfate in toxemia of pregnancy

Abstract

Objective: The universal significance of magnesium sulfate in the treatment of toxemia of pregnancy doesn’t exclude the necessity of the correct pathogenesis - based proves. Nowadays it is believed to be justified to consider the development of toxemia of pregnancy in connection with endothelial dysfunction. That is why the purpose of this research is studying the influence of the treatment with magnesium sulfate on the indicates of intravascular - platelet hemostasis.

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Methods: 101 pregnant women with toxemia of pregnancy have been checked up. The dose of magnesium sulfate (i/v infusions) made 7,5 gr of solid substance by the velocity of infusion 2 gr/hour with the subsequent i/m injections - 6 gr of solid substance at one injection in 4, 4, 4 and 6 hours correspondingly. In the samples of the venous blood before, during and in 24 hours after the treatment the marks of the endothelial dysfunction were defined: the number of circulating endoteliocytes, von Willebrand factor (hard-phase immune-enzyme analysis with monoclonal antibodies), tissular stimulator of plasminogen (photometric method), intravascular platelet aggregation (modified method by Wu and Hoak).

Results: It has been stated that magnesium sulfate in toxemia of pregnancy has an obvious protection effect on endothelium. Thus, after the treatment with magnesium sulfate the number of circulating endotheliocytes in women with nephropathy decrease by 2 times, in women with preeclampsia - by 1,7 times with the absence of changes of the levels of von Willebrand factor and tissular stimulator of plasminogen. Intravascular platelet aggregation obviously decreased: in nephropathy I by 12%, nephropathy II - by 18%, nephropathy III - by 23%, preeclampsia - by 22,4%.

Conclusions: Thus, the results we got showed that the treatment with magnesium sulfate in toxemia of pregnancy decreases the manifestations of the endothelial dysfunction and, so may be regarded as a pathogenesis - based treatment.