Dihydralazine or ketanserin for severe hypertension in pregnancy? Preliminary results
Date
1997
Authors
Steyn D.W.
Odendaal H.J.
Journal Title
Journal ISSN
Volume Title
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Abstract
Objective: To compare the efficacy and safety of intravenous dihydralazine with ketanserin in the management of severe hypertension in the third trimester. Study design: A double blind randomised controlled trial, comparing 5 mg dihydralazine with 10 mg ketanserin after an intravenous infusion of 500 ml of a crystalloid solution. Medication was repeated every 20 min till the therapeutic goal of 90 mm Hg was reached, to a maximum of 4 dosages. Main outcome measures were treatment failures and emergency deliveries for fetal distress. Results: The therapeutic goal was met more often in patients receiving dihydralazine (36/38 compared to 27/42; P<0.01). The need for delivery for fetal distress did not differ (3 after dihydralazine, 1 after ketanserin, P=0.29). No therapy related perinatal loss occurred, but one mother with an undiagnosed phaechromocytoma died 24 h after receiving dihydralazine. Conclusion: Ketanserin in this dosage is less effective to lower diastolic blood pressure. The place of a fluid load prior to dihydralazine needs to be further investigated, as fetal heart rate decelerations were less common-than previously reported.
Description
Keywords
dihydralazine, ketanserin, adult, article, clinical trial, controlled study, crystalloid, double blind procedure, drug efficacy, drug safety, drug screening, female, fetus distress, human, intravenous drug administration, major clinical study, maternal hypertension, priority journal, randomized controlled trial, third trimester pregnancy, treatment outcome, Adult, Antihypertensive Agents, Blood Pressure, Dihydralazine, Double-Blind Method, Female, Fetal Death, Fetal Distress, Heart Rate, Fetal, Humans, Hypertension, Infusions, Intravenous, Ketanserin, Pregnancy, Pregnancy Complications, Cardiovascular
Citation
European Journal of Obstetrics Gynecology and Reproductive Biology
75
2
75
2