Diuretics vs. placebo for postpartum blood pressure control in preeclampsia DIUPRE: a randomized clinical trialReport as inadecuate




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Reproductive Health

, 12:66

First Online: 05 August 2015Received: 21 January 2015Accepted: 15 July 2015DOI: 10.1186-s12978-015-0057-0

Cite this article as: Cursino, T., Katz, L., Coutinho, I. et al. Reprod Health 2015 12: 66. doi:10.1186-s12978-015-0057-0

Abstract

BackgroundHypertension affects about 10 % of pregnancies and is responsible for both maternal and neonatal devastating complications such as eclampsia, HELLP syndrome, prematurity and maternal and neonatal death. The resolution of the disease occurs in the first twelve weeks postpartum. The behavior of blood pressure and occurrence of very high blood pressure episodes among women with severe preeclampsia is related to remodeling of the dynamics of body fluids with consequent increase in intravascular volume. The persistence of hypertension in critical levels results in increased puerperal morbidity.

ObjectivesTo evaluate the effectiveness of furosemide in accelerating blood pressure recovery among women with severe preeclampsia.

Methods-designA triple-masked placebo controlled clinical trial, will be conducted including 120 postpartum women with severe preeclampsia, after eclampsia prophylaxis with magnesium sulfate and with adequate diuresis. Women with chronic hypertension and users of diuretics will be deleted. Informed consent will be obtained from all participants. Patients will be randomized to receive furosemide 40 mg orally every twenty four hours or placebo. The variables are systolic and diastolic blood pressure, frequency of hypertensive crises, need for maintenance of antihypertensive therapy, number of antihypertensive agents used to control blood pressure, urine output, length of hospital stay, adverse effects and maternal complications. This study was approved by the Research Ethics Committee in humans of our institution. All participants will be duly informed about the aims of the project and will be included only if they agree to participate voluntarily, signing the informed consent.

Trial registrationThis study was registered on Clinical Trials.gov under the number NCT02163655. http:-clinicaltrials.gov-show-NCT02163655.

KeywordsPreeclampsia Very high blood pressure Diuretics Randomized controlled trial AbbreviationsIMIPInstituto de Medicina Integral Prof. Fernando Figueira

SBPSystolic blood pressure

BDPDiastolic blood pressure

MAPMean blood pressure

NNHNumber needed to harm

NNTNumber needed to treat

CONEPNational Committee for Ethics in Research of the Brazilian Ministry of Health

ICUIntensive care unit

RCTRandomized controlled trial

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Author: Telma Cursino - Leila Katz - Isabela Coutinho - Melania Amorim

Source: https://link.springer.com/



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