Differences in Plasma Endothelin-1 Levels Before and After MgSO4 Administration in Pregnant Women with Preeclampsia

Introduction: Preeclampsia (PE) is a major cause of maternal morbidity and mortality, particularly in low-resource settings. Although Magnesium Sulfate (MgSO4) is the standard treatment for preventing eclampsia, its precise effects on vascular function, especially regarding Endothelin-1 (ET-1) levels, remain unclear. ET-1, a potent vasoconstrictor, is elevated in hypertensive disorders of pregnancy, contributing to endothelial dysfunction in PE. This study aims to investigate the impact of MgSO4 therapy on plasma ET-1 levels in pregnant women diagnosed with severe PE. Method: This observational follow-up study was conducted at RSUP Prof. Dr. I. G. N. G. Ngoerah, Denpasar, starting in October 2022. Participants included pregnant women with severe PE, aged 20–40 weeks of gestation, receiving MgSO4 therapy. Patients with chronic conditions such as diabetes or pre-existing hypertension were excluded. Blood samples were collected before and after MgSO4 administration, and plasma ET-1 levels were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analysis was conducted using the Wilcoxon test, with a significance level set at p < 0.05. Results: A total of 31 participants, with a mean age of 32.09 ± 6.48 years, were included. Most patients were nulliparous (32.3%) and had a single marriage history (71.0%). Baseline characteristics showed high systolic and diastolic blood pressures (mean 165 and 110 mmHg, respectively), elevated MAP (131 mmHg), and significant proteinuria (+3 in 38.7% of cases). Laboratory results indicated abnormal levels of AST, ALT, LDH, and creatinine, with an average platelet count of 241.35 ± 69.77 x 103/L. Following MgSO4 therapy, ET-1 levels significantly decreased from a median of 12.45 ng/mL to 5.55 ng/mL (p = 0.004), suggesting an improvement in endothelial function. Conclusion: The study findings suggest that MgSO4 not only prevents seizures but also plays a role in reducing vasoconstriction in PE patients through the modulation of ET-1 levels. This supports the potential use of ET-1 as a marker to evaluate the therapeutic efficacy of MgSO4 in PE management, highlighting MgSO4’s broader vascular benefits in treating PE.