الفهرس 
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Abstract
Preeclampsia is a multisystem disorder that complicates pregnancies and remains a major cause of maternal, fetal, and neonatal morbidity and mortality. Preeclampsia is characterized by the development of new onset hypertension (HTN) and the establishment of proteinuria. Other signs and symptoms that accompany the disease include headache, visual disturbances, epigastric or abdominal pain, weakness, altered mental status, HELLP syndrome dyspnea and edema (Chappell et al., 2021).
There is evidence from several studies that preeclampsia is accompanied by endothelial injury. This injury results in abnormal vascular relaxation and platelet activation and is associated with inflammation and oxidative imbalance. The activation of the inflammatory cascade that occurs in normal pregnancy is further exaggerated in preeclampsia. Markers of inflammation, such as high-sensitivity C-reactive protein (hs-CRP), are elevated in patients who later develop preeclampsia. In addition, preeclampsia is associated with elevated cytokines such as tumor necrosis factor-α, interleukin-6 (IL-6), and IL-12. These activate the inflammatory cascade and increase free radical generation and oxidative stress, thus contributing to endothelial injury (Pennington et al., 2012).
This study aimed to evaluate the effects of preoperative oral administration of rosuvastatin on the resolution of biochemical features (CRP and IL-6) in severe preeclampsia parturient in the third trimester following delivery. The primary outcome was to measure the levels of IL-6 and CRP in severe preeclampsia patients in the third trimester at admission, immediately after delivery and 4 days after delivery. Secondary outcomes included the hemodynamic variables, laboratory tests, new symptoms consistent with possible worsening of severe PE or complications, side effects from rosuvastatin and neonatal evaluation by fetal umbilical arterial blood gases and the APGAR score at the first and fifth minute of birth.
This prospective interventional double-blinded randomized controlled clinical trial was conducted on 90 severely preeclamptic women (age 20-35years old) singleton no anomalous pregnancy and normal lipid profile and normal liver transaminases. Patients were randomly allocated into three equal groups of 30 patients each and received study drug orally once daily. Treatment was started on admission and continued 3 to 5 days before delivery according to the allocated group. Parturients in group I received placebo, group II received 20 mg rosuvastatin and group III received 40 mg rosuvastatin.
Results of our study showed that CRP was significantly increased in parturients of group I when compared to group II and III immediately after delivery. There were no statistically significant differences between the three studied groups at base line and at 4-days after delivery. Inside each group, there were statistically significant differences in CRP values as compared to the baseline. IL-6 was significantly decreased in parturients of group II and III when compared to that of group I after delivery. There were no statistically significant differences between the three studied groups at baseline and 4-days after delivery. Inside group III, there were statistically significant differences in IL-6 values as compared to the baseline. Inside groups I & II, there were no statistically significant differences in IL-6 values as compared to the baseline.
Our result revaled as regarding as fetal outcome, there were no statistically significant differences between the three studied groups as regarding the values of pH and PCO2. Also, there were no statistically significant differences between each two groups as regards to pH and PCO2 levels. There were statistically significant differences between the three studied groups as regarding the PaO2 readings immediately after delivery. The PaO2 level was statistically significantly lower in group III when compared with group I but without any clinical implications as these levels were within the normal range for neonates. There was no statistically significant difference between group I & II or between group II & III. There were no statistically significant differences between the three studied groups as regards the APGAR score values at the first and fifth minutes.