Drugs for treatment of very high blood pressure during pregnancy

Duley, Lelia; Meher, Shireen; Jones, Leanne

doi:10.1002/14651858.cd001449.pub3

Cited by 198 publications

(136 citation statements)

References 80 publications

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“…Kemudian, dipantau respons terhadap pengobatan yaitu dengan memastikan terjadi penurunan tekanan darah, mengidentifikasi efek samping bagi ibu dan janin, memodifikasi pengobatan sesuai dengan respons, pertimbangkan untuk menggunakan < 500 ml cairan kristaloid sebelum atau pada saat yang sama dengan dosis pertama hydralazine yang bertujuan untuk menjaga tekanan darah di bawah 150/100 mmHg. 19 Pengaruh tekanan darah sistolik terhadap kematian pada ibu pre-eklampsia tidak terlihat dengan jelas. Beberapa hasil penelitian masih menunjukkan hasil yang kontradiktif.…”

Section: Pembahasanunclassified

Pre-eklampsia Berat dan Kematian Ibu

Muhani

Besral

2015

Kesmas: National Public Health Journal

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AbstrakPre-eklampsia berat, salah satu penyebab utama kematian ibu di Indonesia dan di RSUD Dr. H. Abdul Moeloek Lampung, merupakan penyebab kematian ibu nomor satu (47,25%). Penelitian ini bertujuan untuk mengetahui hubungan prediktor pre-eklampsi berat (PEB) yang dinilai dari tekanan darah sistolik, tekanan darah diastolik, proteiunuria, eklampsia, sindrom hemolysis, elevated liver enzymes, low platelets count (HELLP) dengan kematian ibu di RSUD Dr. H. Abdul Moeloek. Penelitian ini menggunakan desain kasus kontrol dengan jumlah sampel 60 kasus dan 120 kontrol. Data diolah dari rekam medis rumah sakit selama periode lima tahun (2010 -2014). Hasil penelitian ini memperlihatkan bahwa sindrom HELLP memiliki risiko kematian ibu 12 kali lebih tinggi (95%CI 2,9 -53,7) dan eklampsia memiliki risiko 12,1 kali lebih tinggi (95%CI 3,6). Tekanan darah diastolik 110 -119 mmHg memiliki risiko 7,4 kali lebih tinggi (95%CI 1,8 -29,2), tekanan darah diastolik ≥ 120 mmHg memiliki risiko 5,5 kali lebih tinggi (95%CI 1,1 -23,1), tekanan darah sistolik > 190 mmHg memiliki risiko 2,1 kali lebih tinggi (95%CI 0,5 -7,4), tekanan darah sistolik 170 -190 mmHg memiliki risiko 1,6 kali lebih tinggi (95%CI 0,5 -4,5), proteinuria +3 memiliki risiko 4,2 kali lebih tinggi (95%CI 0,3 -27,4), proteinuria +4 memiliki risiko 3,2 kali lebih tinggi (95%CI 0,5 -31,7) setelah dikontrol oleh usia ibu, gravida, usia kehamilan, metode persalinan, pemberian diasepam, pendidikan, tempat tinggal, dan pekerjaan. Oleh karena itu, perlu meningkatkan deteksi dini komplikasi kehamilan dan penanganan yang baik kasus preeklampsia untuk mencegah kematian ibu akibat eklampsia dan sindrom HELLP.Kata kunci: Kematian ibu, pre-eklampsia berat, sindrom HELLP Abstract Severe preeclampsia, one of main causes of maternal death in Indonesia and at Dr. H. Abdul Moeloek Lampung Public Hospital, is the leading cause Pre-eklampsia Berat dan Kematian Ibu Severe Preeclampsia and Maternal DeathNova Muhani*, Besral** of maternal death (47.25%). This study aimed to determine relation of severe preeclampsia predictor as assessed from systolic blood pressure, diastolic blood pressure, proteiunuria, eclampsia and HELLP syndrome with maternal death at Dr. H. Abdul Moeloek Public Hospital. This study used case control design with 60 cases and 120 control total of sample. Data was managed from hospital medical records during five years period (2010 -2014). Results of study showed HELLP syndrome had risk of maternal death 12 times higher (95%CI 2.9 -53.7) and eclampsia had the risk 12.1 times higher (95%CI 3.8 -38.6). Then diastolic blood pressure 110 -119 mmHg had the risk 7.4 times higher (95%CI 1.8 -29.2), diastolic blood pressure ≥ 120 mmHg had the risk 5.5 times higher (95%CI 1.1 -23.1), sistolic blood pressure > 190 mmHg had the risk 2.1 times higher (95%CI 0.5 -7.4), sistolic blood pressure 170 -190 mmHg had the risk 1.6 times higher (95%CI 0.5 -4.5), proteinuria +3 had the risk 4.2 times higher (95%CI 0.3 -27.4), proteinuria +4 had the risk 3.2 times higher (95%CI 0.5 -31.7) after...

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Section: Pembahasanunclassified

Pre-eklampsia Berat dan Kematian Ibu

Muhani

Besral

2015

Kesmas: National Public Health Journal

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“…This is not recommended based on the results of trials. 27 Although observational studies suggest that there may be some transient lowering of BP 30 minutes after administration of 2 to 5 g of IV magnesium sulphate, usually in patients with preeclampsia, a sustained antihypertensive effect cannot be anticipated. [28][29][30][31] The majority of these women (approximately 75%) will require antihypertensive therapy even while on magnesium sulphate and approximately 50% will require rapid-acting medication to lower BP acutely.…”

Section: Geographica and Income Distribution Of Identi Ed Emls In 14mentioning

confidence: 99%

Pharmacotherapy for Preeclampsia in Low and Middle Income Countries: An Analysis of Essential Medicines Lists

Lalani

Firoz

Magee

et al. 2013

Journal of Obstetrics and Gynaecology Canada

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Objective: To determine the prevalence of drugs for comprehensive management of preeclampsia in national essential medicine lists (EMLs) in low and middle income countries (LMICs) Methods:We collected EMLs from the 144 LMICs identi ed by the World Bank through broad-based Internet searches and in collaboration with the World Health Organization We identi ed therapies for hypertension, eclampsia, preeclampsia complications (eg, pulmonary edema, thrombosis), preterm birth, and labour induction contained in the EMLs Resuts:In 91 EMLs obtained from 144 LMICs, the most commonly listed parenteral antihypertensive therapies were verapamil (637%), hydralazine (615%), sodium nitroprusside (483%), and propranolol (396%) The most prevalent oral antihypertensive therapies were nifedipine (956%), methyldopa (934%), propranolol (901%), and atenolol (879%) For eclampsia/ preeclampsia, magnesium sulphate was present in 846% of EMLs and calcium gluconate in 857% For pulmonary edema, most EMLs (945%) listed oral furosemide, for thrombosis 923% listed heparin, for acceleration of fetal pulmonary maturity 901% listed parenteral dexamethasone, and for labour induction 978% listed oxytocin or a prostanoid (usually misoprostol, 407%) Concusion: EMLs of LMICs provide comprehensive coverage of preeclampsia pharmacotherapy These EMLs may be used as advocacy tools to ensure the availability of these therapies within each country RésuméObjectif : Déterminer la prévalence des médicaments permettant la prise en charge exhaustive de la prééclampsie au sein des listes de médicaments essentiels (LME) nationales des pays ne disposant que d'un revenu faible ou moyen (PRFM)Méthodes : Nous avons regroupé les LME des 144 PRFM identi és par la Banque mondiale par l'intermédiaire de recherches généralisées sur Internet et en collaboration avec l'Organisation mondiale de la santé Nous avons identi é, au sein des LME, les traitements visant l'hypertension, l'éclampsie, les complications de la prééclampsie (p ex oedème pulmonaire, thrombose), l'accouchement préterme et le déclenchement du travailRésutats : Au sein des 91 LME obtenues auprès de 144 PRFM, les traitements antihypertenseurs parentéraux apparaissant le plus couramment ont été les suivants : vérapamil (63,7 %), hydralazine (61,5 %), nitroprussiate de sodium (48,3 %) et propranolol (39,6 %) Les traitements antihypertenseurs oraux les plus prévalents ont été les suivants : nifédipine (95,6 %), méthyldopa 216 l MARCH JOGC MARS 2013 OBSTETRICS (93,4 %), propranolol (90,1 %) et aténolol (87,9 %) Pour ce qui est de l'éclampsie / la prééclampsie, le sulfate de magnésium gurait dans 84,6 % des LME et le gluconate de calcium, dans 85,7 % de celles-ci Pour ce qui est de l'oedème pulmonaire, le furosémide oral gurait dans la plupart des LME (94,5 %); pour ce qui est de la thrombose, l'héparine gurait dans 92,3 % des LME; pour ce qui est de l'accélération de la maturité pulmonaire foetale, la dexaméthasone parentérale gurait dans 90,1 % des LME; et pour ce qui es...

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“…They concluded that until better evidence is available, the choice of antihypertensive should depend on what is known about adverse drug effects and how familiar the clinician is with use of a particular drug. 5 Tabasi et al also found the two drugs to be similar in the control of hypertension. 6 In study by De Pasquale et al the number of doses to achieve control of blood pressure was 1.4 and 1.3 in Hydralazine and Labetalol groups respectively and the difference was not significant (p=0.25).…”

Section: Discussionmentioning

confidence: 95%

Comparison of intravenous hydralazine and intravenous labetalol in the management of severe hypertensive disorders of pregnancy: a tertiary care centre study

Verma¹,

Gupta²,

Bhagat³

et al. 2018

Int J Reprod Contracept Obstet Gynecol

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INTRODUCTIONHypertensive disorders complicate 5 to 10 per cent of all pregnancies, and together they are one member of the deadly triad along with haemorrhage and infection that contributes greatly to maternal morbidity and mortality. Of these disorders, the pre-eclampsia syndrome, either alone or superimposed on chronic hypertension, is the most dangerous.1 Although, there is a lack of agreement regarding the blood pressure levels at which to initiate antihypertensive therapy, there is no debate that severe hypertension (i.e. systolic pressure >160 mmHg and /or diastolic pressure >110 mmHg) should be treated to prevent maternal and the consequent fetal complications. 2Women with pre-eclampsia, without differentiating the severity of the disease, are predisposed to develop complications such as abruptio placentae, disseminated intravascular coagulation, cardiopulmonary complications (pulmonary edema), cerebral hemorrhage, hepatic rupture, hepatic insufficiency and death. The fetal complications are the reduction of the oxygen and nutrient supply leading to fetal growth restriction (FGR), ABSTRACTBackground: Severe hypertension in pregnancy (SBP ≥160 mmHg &/or DBP ≥ 110 mmHg) must be treated judiciously to prevent maternal and fetal complications. The study was conducted to compare the efficacy, adverse effects, maternal and fetal outcome between Hydralazine and Labetalol which are the most commonly used drugs for the purpose. Methods: In a prospective study, 130 pregnant patients each with severe hypertension presenting to SMGS Hospital Jammu were randomized in 2 groups and administered hydralazine or labetalol intravenously. The efficacy of the two drugs was measured in terms of number of doses required to obtain target BP and the timing to achieve the same. The incidence of adverse effects, maternal and fetal outcomes were also compared. Comparisons among the two groups was performed by using independent Student's t test for normally distributed variables, Fishers' exact test, and Pearson Chi Square test for categorical variables. The level of significance was set at p<0.05 for all analysis. Results: There was no statistical difference between the two drugs in terms of efficacy. Significantly more low-birth weight infants were born in the hydralazine group. Also, the adverse effects were significantly more in the hydralazine group. Conclusions: Both hydralazine and labetalol can be used to treat hypertensive emergencies of pregnancy but hydralazine is associated with more side effects.

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Drugs for treatment of very high blood pressure during pregnancy

Cited by 198 publications

References 80 publications

Pre-eklampsia Berat dan Kematian Ibu

Pre-eklampsia Berat dan Kematian Ibu

Pharmacotherapy for Preeclampsia in Low and Middle Income Countries: An Analysis of Essential Medicines Lists

Comparison of intravenous hydralazine and intravenous labetalol in the management of severe hypertensive disorders of pregnancy: a tertiary care centre study

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