Clinical research of low-molecular-weight heparin calcium in treatment of early onset severe pre-eclampsia

Abstract

Objective To explore the clinical effects of low-molecular-weight heparin calcium in treatment of early onset severe pre-eclampsia (PE) and its influence on coagulation function and hepatorenal function. Methods From December 2011 to December 2015, a total of 51 cases of inpatients with early onset severe PE in Shanghai Changning Maternity & Child Health Hospital were selected as research subjects. According to their treatment methods, they were divided into observation group (n=25, treated with conventional treatment and low-molecular-weight heparin calcium) and control group (n=26, only treated with conventional treatment). The clinical index including 24 hours quantitative urinary protein, 24 hours urinary volume, mean arterial blood pressure (MABP), diastolic pressure, blood platelet counts, hematocrit (HCT), coagulation function and hepatorenal function, bleeding volume at each observation point during and after cesarean section, extended pregnancy time and incidence of complications between the two groups were analyzed by statistical methods. There were no significant differences among age, gestational age, gravidity and parity between the two groups (P>0.05). Results ①After treatment, the media extended pregnancy time in observation group was longer than that in control group, and the difference was statistically significant (Z=2.922, P=0.003). On the 3rd and 7th day of treatment, the 24 hours quantitative urine protein in observation group both were lower than those in control group, and both the differences were statistically significant (Z=2.023, P=0.032; Z=2.546, P=0.021). On the 7th and 10th day of treatment, the 24 hours urinary volumes in observation group both were higher than those in control group, and both the differences were statistically significant (Z=2.553, P=0.011; Z=2.233, P=0.026). On the 3rd day of treatment, the MABP in observation group was lower than that in control group, and the difference was statistically significant (t=2.825, P=0.007). On the 3rd and 7th day of treatment, HCT in observation group both were lower than those in control group, and both the differences were statistically significant (t=3.117, P=0.001; t=2.546, P=0.021). On the 3rd, 7th, 10th and 14th day of treatment, the activated partial thromboplastin time (APTT) in observation group all were statistically longer than those in control group, and all the differences were statistically significant (P 0.05). Conclusions Low-molecular-weight heparin calcium in the treatment of early onset severe PE can control the intensive blood pressure, reduce the level of urine protein, inhibit the blood hypercoagulable state caused by the damage of vascular endothelium, may improve the renal function, and extend the pregnancy time without increasing the adverse pregnancy outcomes of mother and infant. Key words: Pre-eclampsia; Low-molecular-weight heparin calcium; Coagulation function; Hepatorenal function; Expectation treatment