A comparative study of the use of epoprostenol and dihydralazine in severe hypertension in pregnancy.
OBJECTIVE
To compare the antihypertensive effects of epoprostenol sodium (prostacyclin) with that of dihydralazine in acute hypertensive crises of pregnancy.


METHODS
A prospective randomized study. A minimum of 20 patients per group was considered statistically acceptable (alpha = 0.05, power = 0.9).


METHODS
A large urban tertiary hospital.


METHODS
Forty-seven pregnant patients with diastolic blood pressures of > 100 mmHg were studied.


METHODS
Lowering of high blood pressure with either dihydralazine (n = 25), the standard drug for this purpose, or epoprostenol (n = 22).


METHODS
A significant drop in high blood pressure was regarded as a fall of 15 mmHg diastolic and 30 mmHg systolic blood pressure.


RESULTS
There were no statistically significant differences in the antihypertensive effects between the two treatment groups. Epoprostenol infusion caused less tachycardia; the mean pulse rate changed from 81.77 beats/min, before treatment to 88.36 at stabilization, compared with a change from 80.96 beats/min to 102.68 in the group treated with dihydralazine (P = 0.0024).


CONCLUSIONS
The place of epoprostenol in pregnancy might be in patients with severe hypertension and tachycardia and in those requiring acute control of severe hypertension on the operating table before general anaesthesia.
Moodley
J
J
Faculty of Medicine, University of Natal Durban, South Africa.
Gouws
E
E
D000328:Adult; D004078:Dihydralazine / Q000627:therapeutic use*; D011464:Epoprostenol / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011446:Prospective Studies; D011674:Pulse / Q000187:drug effects
D011464:Epoprostenol; D004078:Dihydralazine