Objective. To asses the effects on increasing in blood pressure after administration of methylergonovine maleat in patients with severe preeclampsia.
Place of study. This study was conducted in dr. Sardjito Hospital, Yogyakarta, Indonesia from January – April 2010.
Study design. This study used method of prospective cohort to subject who eligible the inclusion.
Methods. The subject in this study were pregnant women with severe preeclampsia. Fifty five participants were divided into two groups. The first group (n=33) was treated with injection of methyergonovine maleat intra muscular in third stage of labor (after delivery of placenta) and the second group (n=22) was control group which mean had no intervention with methylergonovine maleat.
Results. After statistical test analysis paired t-test and independent t-test were done, there was a significant (p0,05) mean systolic pressure before administration of metylergonovine (148.8 mmHg) and 60 minutes after injection(151.8 mmHg). Significant difference between control group and the group which treated with metylergonovine was clearly demonstrate with increased of systolic and diastolic pressure at 30 minutes and 60 minutes following metlergonovine administration (p Conclusion. Administration of methylergonovine maleat via intra muscular injection may trigger the event of increasing systolic and diastolic pressure although clinically was not significant. Thus, if any indication on using of methylergonovine in third stage of labor which complicated with severe preeclampsia, adequate observation of the patients was required.
Background: Placenta is a central and important focus on the pathogenesis of preeclampsia. Failure of trophoblast cell to the spiral arteries remodeling process due to excessive apoptosis causes uteroplacenter ischaemia and damage of endothelial cells that give rise to clinical manifestations of preeclampsia. Excessive throphoblast apoptosis in preeclampsia mainly occurs through the intrinsic pathway in which expression of Bax protein increases mitocondrial membranes permeability of cytochrom C which further activate the caspase cascade and become involved in the process of cell death. Objective: To compare the expression of Bax protein and throphoblastic apoptosis process between severe preeclampsia/eclampsia and the normotensive pregnancy. Methods: Cross sectional study which consist of 43 severe preeclampsia/eclampsia pregnancies and 38 third trimester normotensive pregnancies, recruited between October 2011 – March 2012. Trophoblastic Bax protein expression is measured by imunohistochemical staining technique and trophoblast apoptosis process is examined by the Tunel assay. Statistical analysis using the independent t test (p<0.05). Results: Bax protein expression was significantly higher in trophoblast cell of severe preeclampsia/eclampsia compared to normotensive pregnancy (1.7 vs 1.4, p=0.00). Bax expression positively correlated (r=0.01) with mean arterial pressure which is increasing of the mean arterial pressure will increase the expression of the Bax protein. There was no significant difference in trophoblastic apoptosis index between severe preeclampsia/eclampsia pregnancy and normotensive pregnancy (23.8 vs 35.5, p= 0.10). Conclusions: Bax protein expression was significantly higher in severe preeclampsia/eclampsia than normotensive pregnancy. There was no significantly difference in trophoblast apoptosis index between severe preeclampsia/eclampsia and normotensive pregnancy. Keywords: trophoblast, severe preeclampsia/eclampsia, Bax protein, apoptosis.