Dihydralazine or ketanserin for severe hypertension in pregnancy? Preliminary results

European Journal of Obstetrics, Gynecology, and Reproductive Biology
D W Steyn, H J Odendaal

Abstract

To compare the efficacy and safety of intravenous dihydralazine with ketanserin in the management of severe hypertension in the third trimester. 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. 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. 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.

References

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Citations

Aug 29, 1998·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·J T Repke, J N Robinson
Mar 27, 2001·European Journal of Obstetrics, Gynecology, and Reproductive Biology·A C BolteG A Dekker
Apr 13, 2002·European Journal of Obstetrics, Gynecology, and Reproductive Biology·Debby L van SchieHerman P van Geijn
Sep 7, 2000·Obstetrical & Gynecological Survey·D W Steyn, H J Odendaal
Apr 5, 2005·Clinical Obstetrics and Gynecology·Peter von Dadelszen, Laura A Magee
Oct 25, 2003·BMJ : British Medical Journal·Laura A MageePeter von Dadelszen
Aug 2, 2001·Best Practice & Research. Clinical Obstetrics & Gynaecology·F Paruk, J Moodley
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Jul 6, 2018·British Journal of Clinical Pharmacology·Kannan Sridharan, Reginald P Sequeira
Jul 14, 2007·The Australian & New Zealand Journal of Obstetrics & Gynaecology·Annemarie HennessyAndrew Child
Aug 1, 2013·The Cochrane Database of Systematic Reviews·Lelia DuleyLeanne Jones
Feb 8, 2014·The Cochrane Database of Systematic Reviews·Edgardo AbalosD Wilhelm Steyn

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