| Background:Gestational hypertension is a peculiar disease during pregnancy.Hypertensive disorders of pregnancy are important contributors to the global burden of maternal mortality,accounting for 12.9 and 14% of maternal deaths in high-income countries and low-and middle-income countries,respectively.It is a multiple system function disorder during pregnancy,primarily occurs after 20 weeks of gestation,severe cases may be lead to preeclampsia and eclampsia.For preeclampsia,spasmolysis is the important ways for its treatment,not only it can remove the spasm of systemic small artery,but also can relieve the clinical symptoms,prevent the happen of eclampsia,the preferred drug is magnesium sulfate.Although the application of magnesium sulfate for the treatment of preeclampsia and eclampsia has certain clinical curative effect,but its doses is still quite controversial in some aspects.Objective:To evaluate the efficacy of different doses of using the magnesium sulfate for treatment the pregnant woman of preeclampsia and eclampsia by the method of Meta-analysis.Magnesium sulfate to the clinical work provide reliable clinical basis for treatment of preeclampsia and eclampsia.In order to provide reliable theoretical basis for clinical work.Methods:A number of online database include Pubmed、Medline、Embase、Cochrane、Web of science、CNKI、Wanfang database,Weipu database were comprehensively retrieved.Limit for Chinese and English languages.two reviewers collect all the literatures which from January 1990 to January 2017.Excluding those not in conformity with the purpose of this paper study or do not conform to the quality of the article.Then both of them screen documents independent,bring into studies met criteria,evaluate the included studies,data extraction and data conversion dependently.Finally,use Rev Man 5.3 software offered by the Cochrane collabiration to complete the Meta-analysis.Results:This Meta-analysis has collected nine articles,a total of 1429 pregnant women,the experimental group include 569 pregnant women with magnesium sulfate alternatives,the control group include 860 pregnant women with Standard of Pritchard.The meta-analysis showd:(1)among the included nine groups,compared with the standard scheme,low dosage regimens for prevent the occurrence of eclampsia(OR=1.40,95%CI(0.79,2.48),P=0.25)and maternal mortality(OR=0.83,95%CI(0.43,1.64),P=0.6)was not noted significant difference.The difference was not statistically significant.(2)among the included seven groups,compared with the standard scheme,low dosage regimens can reduce eclampsia pregnant fetal and neonatal mortality(OR=0.61,95%CI(0.43,0.87),P=0.006),the difference was statistically significant.Compared with the standard scheme,low dosage regimens for preeclampsia pregnant was not noted significant difference fetal and neonatal mortality(OR=0.48,95%CI(0.21,1.08),P=0.08),the difference was not statistically significant.(3)among the included four groups,compared with the standard scheme,Only load dosage regimens for prevent the occurrence of eclampsia(OR=1.70,95%CI(0.46,6.33),P=0.43)and maternal mortality(OR=1.11,95%CI(0.18,6.95),P=0.91)was not noted significant difference.The difference was not statistically significant.(4)among the included four groups,compared with the standard scheme,Only load dosage regimens can reduce eclampsia and preeclampsia pregnant fetal and neonatal mortality(OR=0.45,95%CI(0.23,0.88),P=0.02),the difference was statistically significant.Conclusion:In this paper,the study showed that low dose schemes and only load dosage regimens the same as the standard Prithard scheme in safety and effectiveness for prevent the occurrence of eclampsia and maternal mortality,besides low dose schemes and only load dosage regimens can lower fetal and neonatal mortality preeclampsia and eclampsia pregnant.However,the number of included groups was small,to explore an effective and safe magnesium sulfate dosage regimens of prevention and treatment of preeclampsia and eclampsia,it remains to be further validated with large sample randomized controlled trial. |
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