Document Detail


The hemodynamic effects of intravenous digoxin-binding fab immunoglobulin in severe preeclampsia: a double-blind, randomized, clinical trial.
MedLine Citation:
PMID:  19148110     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: An endogenous digitalis-like factor (EDLF) has been implicated in the pathophysiology of preeclampsia (PE). This hypothesis is supported by two cases of preeclampsia in which administration of digoxin immune Fab (DIF) reduced mean arterial pressure (MAP).
STUDY DESIGN: To study this observation further, we performed a double-blind, placebo-controlled, randomized clinical trial to examine the effects on MAP of intravenous DIF given after delivery in 26 subjects with severe preeclampsia. Treating obstetricians were blinded to subject assignment and were allowed to use standard antihypertensive drugs during the trial.
RESULTS: The primary outcome, a significant difference in blood pressure between the two groups over the 24-h period of observation after the intervention, was not supported. However, mean MAP was significantly lower in the DIF-treated subjects for the first 4 h after therapy as compared with controls (P=0.05). Six subjects (46.2%) in the placebo arm were given conventional antihypertensive medications by their obstetrician for blood pressure >160 mm Hg systolic or >110 mm Hg diastolic, compared with zero subjects in the treatment arm (P=0.01). A trend towards increased creatinine clearance was observed in DIF-treated subjects (137.6+/-42.6 versus 104.1+/-43.4, P=0.07).
CONCLUSION: These results support the hypothesis that EDLF contributes to the elevated blood pressure in preeclampsia and suggests a possible role for DIF as a treatment for this condition.
Authors:
C D Adair; A Luper; J C Rose; G Russell; J-C Veille; V M Buckalew
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial     Date:  2009-01-15
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  29     ISSN:  1476-5543     ISO Abbreviation:  J Perinatol     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-27     Completed Date:  2009-07-30     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  284-9     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Antihypertensive Agents / administration & dosage*
Blood Pressure / drug effects*,  physiology
Creatinine / blood
Double-Blind Method
Female
Humans
Immunoglobulin Fab Fragments / administration & dosage*
Infant, Newborn
Infusions, Intravenous
Labor Stage, Third
Pre-Eclampsia / drug therapy*,  physiopathology
Pregnancy
Young Adult
Grant Support
ID/Acronym/Agency:
R01 HD017644/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Immunoglobulin Fab Fragments; 0/digoxin antibodies Fab fragments; AYI8EX34EU/Creatinine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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