1. Home
  2. Vol 29, No 2 (2025)
  3. Yang

Effectiveness of placental blood perfusion monitoring of nitroglycerin and labetalol in treatment of women with pregnancy-induced hypertension

Zhili Yang(1), Jinhong Zhao(2),


(1) Department of Ultrasound, Jiangxi Maternal and Child Health Hospital, Nanchang 330006, Jiangxi, China
(2) Department of Radiology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang 330066, Jiangxi, China
Corresponding Author

Abstract


This was an original study and elucidated the value of placental blood perfusion monitoring based on quantitative three-dimensional (3D) power Doppler ultrasound in evaluating the efficacy of nitroglycerin and labetalol in treating pregnancy-induced hypertension (PIH). Eighty PIH patients admitted in The Second Affiliated Hospital from October 2021 to October 2023 were divided into mild PIH group (Group A) and severe PIH group (Group B). Another 50 healthy pregnant women without PIH were selected as the control group (CG). Groups A and B received a combination treatment of nitroglycerin and labetalol. The TNF-α levels in Group A and B were higher relative to those in CG. Relative to before treatment, Group A and B had higher vascularization index (VFI), flow index (FI), and placental vascularization index (VI), higher middle cerebral artery pulsatility index (PI) and Apgar scores and lower left uterine artery PI and right uterine artery PI after treatment. After treatment, there was statistical significance in placental VI, FI, and VFI under different efficacy grades. We conclude that the application of quantitative 3D power Doppler ultrasound technology can accurately monitor the therapeutic effect of nitroglycerin and labetalol in treatment of pregnant women with PIH.

References


Magee L, Smith G, Bloch C, CÙtÈ A, Jain V, Nerenberg K,

von Dadelszen P, Helewa M, Rey EJJoo and JOGC

gCJJdoegdC. Guideline No. 426: Hypertensive

Disorders of Pregnancy: Diagnosis, Prediction,

Prevention, and Management. 2022; 44(5):547-

e1.

Antza C, Stabouli S and Kotsis VJJoh. Practical guide for the

management of hypertensive disorders during

pregnancy. 2022; 40(7):1257-1264.

Khedagi A and Bello NJCc. Hypertensive Disorders of

Pregnancy. 2021; 39(1):77-90.

Sharma G, Hays A, Blumenthal RJJotACoC. Can We

Reduce Premature Mortality Associated With

Hypertensive Disorders of Pregnancy?: A Window

of Opportunity. 2021; 77(10):1313-1316.

Garovic V, Dechend R, Easterling T, Karumanchi S,

McMurtry Baird S, Magee L, Rana S, Vermunt J,

August P and JH. Hypertension in Pregnancy:

Diagnosis, Blood Pressure Goals, and

Pharmacotherapy: A Scientific Statement From the

American Heart Association. 2022; 79(2):e21-e41.

Sundstrˆm J, Lind L, Nowrouzi S, Hagstrˆm E, Held C,

Lytsy P, Neal B, Marttala K and ÷stlund OJJ.

Heterogeneity in Blood Pressure Response to 4

Antihypertensive Drugs: A Randomized Clinical

Trial. 2023; 329(14):1160-1169.

Bryniarski P, Nazimek K, Marcinkiewicz JJIjoms.

Immunomodulatory Activity of the Most

Commonly Used Antihypertensive DrugsAngiotensin Converting Enzyme Inhibitors and

Angiotensin II Receptor Blockers. 2022; 23(3)

Stergiou G, Brunstrˆm M, MacDonald T, Kyriakoulis K,

Bursztyn M, Khan N, Bakris G, Kollias A, Menti A,

Muntner P, Orias M, Poulter N, Shimbo D,

Williams B, Adeoye A, Damasceno A,

Korostovtseva L, Li Y, Muxfeldt E, Zhang Y,

Mancia G, Kreutz R and Tomaszewski MJJoh.

Bedtime dosing of antihypertensive medications:

systematic review and consensus statement:

International Society of Hypertension position

paper endorsed by World Hypertension League andEuropean Society of Hypertension. 2022;

(10):1847-1858.

Zhang S, Tao L, Yang Y, Kong T, Wu C, Wang Y, Chen J,

Song L, Wang Y, Hui R and Zhang WJCmj.

Evaluation of blood pressure lowering effect by

generic and brand-name antihypertensive drugs

treatment: a multicenter prospective study in China.

; 134(3):292-301.

Cui H, Yu L, Li H, Wang H, Liang W, Wang H and Wang

HJJoar, genetics. Evaluation of placental growth

potential and placental bed perfusion by 3D

ultrasound for early second-trimester prediction of

preeclampsia. 2022; 39(7):1545-1554.

Stampalija T, Quadrifoglio M, Casati D, Zullino S, Maggi

V, Di Martino D, Rosti E, Mastroianni C, Signorelli

V, Ferrazzi EJTjom-f and neonatal medicine : the

official journal of the European Association of

Perinatal Medicine tFoA, Oceania Perinatal

Societies tISoPO. First trimester placental volume

is reduced in hypertensive disorders of pregnancy

associated with small for gestational age fetus.

; 34(8):1304-1311.

Huguelet PS and Galan HL. Emergencies in Obstetrics and

Gynecology: Advances and Current Practice.

Obstet Gynecol Clin North Am. 2022; 49(3):xv-xvi.

Kripfgans OD, Rubin JM, Hall AL, Gordon MB and

Fowlkes JB. Measurement of volumetric flow. J

Ultrasound Med. 2006; 25(10):1305-11.

Ma Y, Ren Y, Dai ZJ, Wu CJ, Ji YH and Xu J. IL-6, IL-8

and TNF-α levels correlate with disease stage in

breast cancer patients. Adv Clin Exp Med. 2017;

(3):421-426.

Li YX, Long DL, Liu J, Qiu D, Wang J, Cheng X, Yang X,

Li RM and Wang G. Gestational diabetes mellitus

in women increased the risk of neonatal infection

via inflammation and autophagy in the placenta.

Medicine (Baltimore). 2020; 99(40):e22152.

Papademetriou V, Stavropoulos K, Patoulias D,

Papadopoulos C, Georgios K, Toumpourleka M and

Sachinidis AJCpd. Hypertension in Pregnancy:

Unanswered Questions. 2021; 27(36):3795-3803.

Issa E, Stevenson G, Gomes De Melo Tavares Ferreira A,

Chang M, Alphonse J, Welsh AJFd and therapy.

The Influence of Hyperoxygenation on Fetal Brain

Vascularity Measured Using 3D Power Doppler

Ultrasound and the Index "Fractional Moving

Blood Volume". 2021; 48(9):651-659.

Liu Y, Gao X, Shi D, Wang Y, Qi X and Wang NJB,

biomedicine. Changes of placental threedimensional power Doppler ultrasonography in

third trimester among hypertensive disorders

complicating pregnancy. 2023; 23(5):894-901.

Li T, Tie H, Qi P and Lv LJJoo, Obstetrics gtjotIo,

Gynaecology. Placental micro blood perfusion for

isolated single umbilical artery foetuses and VEGF

protein expression in the placenta. 2023;

(1):2189480.

Zhou J, Xiong Y, Ren Y, Zhang Y, Li X and Yan YJJocuJ.

Three-dimensional power Doppler ultrasonography

indicates that increased placental blood perfusion

during the third trimester is associated with the risk

of macrosomia at birth. 2021; 49(1):12-19.

Patrick H, Mitra A, Rosen T, Ananth C and Schuster

MJAjoo, gynecology. Pharmacologic intervention

for the management of retained placenta: a

systematic review and meta-analysis of randomized

trials. 2020; 223(3):447.e1-447.e19.

Kaur P, Madan A and Sharma SJAoAm. A comparative

study of transdermal nitroglycerine patch and oral

nifedipine in preterm labor. 2021; 20(1):31-36.

Plouin P, BrÈart G, Maillard F, Papiernik E and Relier

JJAdmdcedv. [Maternal effects and perinatal safety

of labetalol in the treatment of hypertension in

pregnancy. Comparison with methyldopa in a

randomized cooperative trial]. 1987; 80(6):952-5.

Yoon S, Choi G, Seong H, Lee M and Kang HJIjoms.

Pharmacological strategies to prevent

haemodynamic changes after intubation in

parturient women with hypertensive disorders of

pregnancy: A network meta-analysis. 2021;

(4):1039-1050.

Malik M, Ahmad R, Beg M and Ahmad RJIhj. A

comparative study of intravenous labetalol VS

intravenous nitroglycerin in the treatment of

hypertensive crises. 2022; 74(4):332-334.

Godefroy G, Arnal B and Bossy EJSr. Full-visibility 3D

imaging of oxygenation and blood flow by

simultaneous multispectral photoacoustic

fluctuation imaging (MS-PAFI) and ultrasound

Doppler. 2023; 13(1):2961.

Moore L, Wesolowski S, Lorca R, Murray A and Julian

CJAjopR, integrative, physiology c. Why is human

uterine artery blood flow during pregnancy so high?

; 323(5):R694-R699.

Odibo AO, Goetzinger KR, Huster KM, Christiansen JK,

Odibo L and Tuuli MG. Placental volume and

vascular flow assessed by 3D power Doppler and

adverse pregnancy outcomes. Placenta. 2011;

(3):230-4.

Liu Y, Gao X, Shi D, Wang Y, Qi X and Wang N. Changes

of placental three-dimensional power Doppler

ultrasonography in third trimester among

hypertensive disorders complicating pregnancy.

Biomolecules & biomedicine. 2023; 23(5):894-901


Full Text: PDF

Article Metrics

Abstract View : 899 times
PDF Download : 421 times

Refbacks

  • There are currently no refbacks.