Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

Repeated dosing of digoxin-fragmented antibody in preterm eclampsia

Journal of Perinatology volume 29, pages 163–165 (2009)Cite this article

Abstract

Early onset eclampsia has significant morbidity and mortality for both the mother and fetus. No effective treatment exists at present except delivery and seizure prophylaxis with magnesium sulfate. We report the novel use of a fragmented ovine antibody against digoxin for the treatment of eclampsia. A 16-year-old primagravida at 29 weeks 5/7 days gestation presented with clinical diagnosis of eclampsia and was treated with compassionate off-label use of digoxin-fragmented ovine antibody (Digibind Glaxo Smith Kline, Research Triangle Park, NC, USA). Improvement of her underlying disorder during a 48 h treatment window was noted without adverse maternal or neonatal outcome. We suggest digoxin-fragmented ovine antibody as a possible intervention in preterm pregnancies complicated by pre-eclampsia or eclampsia.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Diagnosis and Management of Preeclampsia and Eclampsia. American College of Obstetricians and Gynecologists 2008 Compendium of selected publications: Washington DC, ACOG Practice Bulletin #33, January 2002, pp 717–725.

  2. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC, Wenstrom KD . Hypertensive Disorders in Pregnancy, Williams Obstetrics, 22 ed, McGraw-Hill, New York, 2005, pp 761–808.

    Google Scholar 

  3. Sibai BM . Diagnosis, prevention, and management of eclampsia. Obstet Gynecol 2005; 105: 402–410.

    Article  Google Scholar 

  4. NIH Consensus Development Conference Reaffirms Single Course of Antenatal Corticosteroids for Preterm Women. Cites Insufficient Evidence for Repeat Courses. NIH News Release 18 August 2000. http://consensus.nih.gov.

  5. Sibai BM, Akl S, Fairlie F, Moretti M . A protocol for managing severe preeclampsia in the second trimester. Am J Obstet Gynecol 1990; 163: 733–738.

    Article  CAS  Google Scholar 

  6. Sibai BM, Mercer BM, Schiff E, Friedman SA . Aggressive versus expectant management of severe preeclampsia at 28–32 weeks' gestation: a randomized controlled trial. Am J Obstet Gynecol 1994; 171: 818–822.

    Article  CAS  Google Scholar 

  7. Odendaal HJ, Pattinson RC, Bam R, Grove D, Kotze TJ . Aggressive or expectant management for patients with severe preeclampsia between 28–34 weeks' gestation: a randomized controlled trial. Obstet Gynecol 1990; 76: 1070–1075.

    CAS  PubMed  Google Scholar 

  8. Haddad B, Deis S, Goffinet F, Paniel BJ, Cabrol D, Sibai BM . Maternal and perinatal outcomes during expectant management of 239 severe preeclamptic women between 24 and 33 weeks' gestation. Am J Obstet Gynecol 2004; 190: 1590–1597.

    Article  Google Scholar 

  9. Goodlin RC . Antidigoxin antibodies in eclampsia. N Engl J Med 1988; 318: 518–519.

    Article  CAS  Google Scholar 

  10. Adair CD, Buckalew VM, Taylor K, Ernest JM, Frye AH, Evans C et al. Elevated endoxin-like factor complicating a multifetal second trimester pregnancy: treatment with digoxin-binding immunoglobulin. Am J Nephrol 1996; 16: 529–531.

    Article  CAS  Google Scholar 

  11. Gilson GJ, Graves SW, Qualls CR, Curet LB . Digoxin-like immunoreactive substance and sodium-potassium-adenosine triphosphatase inhibition in normal pregnancy: a longitudinal study. Obstet Gynecol 1997; 89: 743–746.

    Article  CAS  Google Scholar 

  12. Balzan S, Montali U, Genovesi-Ebert A, Biver P, Fantoni M, Ghione S . Comparison between endogenous digoxin-like immunoreactivity and 86RB+ uptake by erythrocytes in extracts of human plasma. Clin Sci 1989; 77: 375–381.

    Article  CAS  Google Scholar 

  13. Garzetti GG, Tranquilli AL, Cugini AM, Mazzanti L, Cester N, Romanini C . Altered lipid composition, increased lipid peroxidation, and altered fluidity of the membrane as evidence of platelet damage in preeclampsia. Obstet Gynecol 1993; 81: 337–340.

    CAS  PubMed  Google Scholar 

  14. Gusdon JP, Buckalew VM, Hennessy JF . A digoxin-like immunoreactive substance in preeclampsia. Am J Obstet Gynecol 1984; 150: 83–85.

    Article  Google Scholar 

  15. Beyer AD, Odendaal HJ, Spruyt LL, Parkin DP . The possible role of endogenous digitalis-like substance in the causation of preeclampsia. SA Mediese Tydskrif 1984; 65: 883–885.

    Google Scholar 

  16. Kaminski K, Rechberger T . Concentration of digoxin-like immunoreactive substance in patients with preeclampsia and its relation to severity of pregnancy-induced hypertension. Am J Obstet Gynecol 1991; 165: 773–776.

    Article  Google Scholar 

  17. Graves SW . Sodium regulation, sodium pump function and sodium pump inhibitors in uncomplicated pregnancy and preeclampsia. Front Biosci 2007; 12: 2438–2446.

    Article  CAS  Google Scholar 

  18. Poston L . Sodium transport inhibitors in pregnancy-inducted hypertension. Cardiovasc Drugs Ther 1990; 4 (Suppl 2): 351–356.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Obstetrics & Gynecology, The Chattanooga Unit, The Section on Maternal-Fetal Medicine, The University of Tennessee College of Medicine, Chattanooga, TN, USA

    C D Adair, J Kipikasa, C Torres, S P Stallings & C M Briery

  2. Department of Internal Medicine, Section on Nephrology, Wake Forest University School of Medicine, Winston-Salem, NC, USA

    V M Buckalew

Authors
  1. C D Adair
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V M Buckalew
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J Kipikasa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C Torres
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. S P Stallings
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. C M Briery
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to C D Adair.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Adair, C., Buckalew, V., Kipikasa, J. et al. Repeated dosing of digoxin-fragmented antibody in preterm eclampsia. J Perinatol 29, 163–165 (2009). https://doi.org/10.1038/jp.2008.181

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2008.181

Keywords

Search

Advanced search

Quick links