Postpartum preeclampsia management with furosemide: A randomized clinical trial
Postpartum preeclampsia management with furosemide: A randomized clinical trial
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DOI：
10.1097/01.aog.0000148270.53433.66
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发表时间：
2005-01-01
影响因子：
7.2
通讯作者：
Martin, JN
中科院分区：
文献类型：
--
作者：
Ascarelli, MH;Johnson, V;Martin, JN
目的：本研究旨在评估产后短疗程的速尿是否能通过增强利尿、减轻重度高血压和减少降压治疗的需要而有利于子痫前期患者的恢复和缩短住院时间。方法：纳入264例先兆子痫患者。在自发性产后利尿并停止静脉注射硫酸镁后，患者被随机分配接受不治疗或每天口服呋塞米20mg，连续5天并口服钾补充剂。根据高血压疾病的分类，比较两组患者的预后。结果：只有产后重度先兆子痫患者（n = 70）在产后第2天收缩压明显低于对照组（142 13 mm Hg比153 19 mm Hg， P < 0.004），住院期间（14%比26%，P = 0.371）和出院时（6%比26%，P = 0.045）需要的降压治疗较少。轻度先兆子痫（n = 169）或叠加性先兆子痫（n = 25）患者无获益。住院时间和迟发性产后并发症的发生频率均未受到干预的积极影响。结论：产后短暂速尿治疗重度先兆子痫患者似乎可以通过更快地使血压正常化和减少降压治疗的需要来促进恢复。缩短住院时间和减少迟发性产后并发症没有好处。(C) 2005年由美国妇产科医师学会出版。
OBJECTIVE: This investigation was undertaken to estimate whether a brief postpartum course of furosemide for patients with preeclampsia benefits recovery and shortens hospitalization by enhancing diuresis, lessening severe hypertension, and reducing the need for antihypertensive therapy.METHODS: Two hundred sixty-four patients with preeclampsia were enrolled. After spontaneous onset of postpartum diuresis and discontinuation of intravenous magnesium sulfate, patients were randomly assigned to receive either no therapy or 20 mg oral furosemide daily for 5 days with oral potassium supplementation. Patient outcomes were compared between treatment groups with regard to classification of hypertensive disease.RESULTS: Only postpartum patients with severe preeclampsia (n = 70) who received furosemide compared with controls had significantly lower systolic blood pressure by postpartum day 2 (142 13 mm Hg compared with 153 19 mm Hg, P < .004) and required less antihypertensive therapy during hospitalization (14% compared with 26%, P = .371) and at discharge (6% compared with 26%, P = .045). No benefit was shown for patients with mild preeclampsia (n = 169) or superimposed preeclampsia (n = 25). Neither length of hospitalization nor frequency of delayed postpartum complications was positively affected by the intervention.CONCLUSION: Brief postpartum furosemide therapy for patients with severe preeclampsia seems to enhance recovery by normalizing blood pressure more rapidly and reducing the need for antihypertensive therapy. Shortening of hospitalization and reduction of delayed postpartum complications were not benefitted. (C) 2005 by The American College of Obstetricians and Gynecologists.