Hydralazine was the most common drug for others to be evaluated against .
Diazoxide , given as 75 mg bolus injections , appears to be associated with maternal hypotension requiring treatment , and ketanserin is less effective than hydralazine at reducing blood pressure .
There is no other clear evidence that any one of the other antihypertensive agents is better than another for women with severe hypertension during pregnancy .
Exceptions are diazoxide and ketanserin , which are probably not good choices
BACKGROUND Very high blood pressure during pregnancy poses a serious threat to women and their babies .
The use of drugs to lower blood pressure will reduce this risk for the women , and possibly also for the baby .
OBJECTIVES The objective of this review was to compare different antihypertensive drugs used for treatment of severe hypertension during pregnancy .
Efficacy of AT in pre-eclampsia: a case-control prospective trial.
Pre-eclampsia is an extremely severe condition . It is associated with vasospasm , activation of the coagulation system and abnormal haemostasis . In pre-eclamptic patients increased plasmatic concentrations of fibronectin , laminin , von Willebr and factor ( VWF ) and endothelin are observed . Experimental studies on rats have also shown that the doses of antithrombin III ( AT ) needed to mediate anti-inflammatory processes are much higher than those required to obtain the anti-coagulant effect . The study aim ed to evaluate the clinical efficacy of treatment with high AT doses ( HD ) in comparison with st and ard doses ( SD ) . The primary endpoint was the prolongation of pregnancy defined as time ( in days ) from enrollment to delivery and to assess the maternal bleeding at and after delivery . The secondary endpoint was to demonstrate a role for AT in controlling haemostasis at conventional doses , and the inflammatory state at higher doses . The biochemical parameters assessed were : AT activity ( % ) , Fibronectin ( Fn ) , Fibrinogen , D-dimer , Uricemia , Proteinuria 24h , Protein C Reactive ( PCR ) , Granulocyte Elastase and Endothelin . This study included 23 pre-eclamptic women . Patients were r and omly subdivided into two groups : 10 patients ( " cases " ) were treated with high doses of AT ( 6 vials : 3000 units ) once daily for 5 days , or until delivery , while 13 women ( " controls " ) were treated with doses of AT sufficient to maintain at least 80 % of the activity . High-dose therapy was associated with prolongation of pregnancy by 2.5 days more when compared with controls ( p = 0.03 ; Mann-Whitney test ) . The incidence of clinical significant bleeding was lower in cases than in controls ( mean 550 mL vs. 650 mL , respectively ) . Preventive- and conservative-type treatment of moderate-severe pre-eclampsia , based on the administration high doses of AT , allows a significant prolongation of pregnancy , and thus a better neonatal outcome , as well as less maternal intra- and post-operative bleeding . Fn , PCR and elastase levels ( markers of inflammation ) decrease in the HD group in comparison with SD group . In the HD group , the AT plasma levels were obviously higher both at the end of the treatment ( p < 0.0001 ) and after delivery ( p = 0.03 ) , in comparison with SD group . The fibrinogen and D-dimer levels were above the reference interval in both groups . TPA and PAI 1 were found to be significantly raised in the course of pre-eclampsia . In conclusion , the bio-chemical findings support a role for AT in controlling the haemostasis at conventional doses , and the inflammatory state at higher doses
Hydralazine was the most common drug for others to be evaluated against .
Diazoxide , given as 75 mg bolus injections , appears to be associated with maternal hypotension requiring treatment , and ketanserin is less effective than hydralazine at reducing blood pressure .
There is no other clear evidence that any one of the other antihypertensive agents is better than another for women with severe hypertension during pregnancy .
Exceptions are diazoxide and ketanserin , which are probably not good choices
BACKGROUND Very high blood pressure during pregnancy poses a serious threat to women and their babies .
The use of drugs to lower blood pressure will reduce this risk for the women , and possibly also for the baby .
OBJECTIVES The objective of this review was to compare different antihypertensive drugs used for treatment of severe hypertension during pregnancy .