Ketanserin versus dihydralazine in the management of severe early-onset preeclampsia: maternal outcome.
OBJECTIVE
An open, randomized, prospective, multicenter trial was conducted to compare the efficacy and safety of intravenous ketanserin, a selective serotonin 2 receptor blocker, with that of intravenous dihydralazine in the management of severe early-onset (<32 weeks' gestation) preeclampsia. End points of this study were blood pressure control and maternal outcome.


METHODS
Patients with a diastolic blood pressure >110 mm Hg were randomly assigned to receive either ketanserin (n = 22) or dihydralazine (n = 22) as initial therapy. Plasma volume expansion preceded antihypertensive treatment, which was administered according to a fixed schedule.


RESULTS
The reductions in blood pressure with the 2 drugs were similar; however, adequate blood pressure control was reached significantly earlier with ketanserin (84 +/_ 63 vs 171 +/- 142 minutes, P = .017). Occurrence of maternal complications was significantly lower among patients who received ketanserin than among patients who received dihydralazine (n = 6 vs n = 18, P =.0007). A significant difference in favor of ketanserin was noted in daily fluid balance.


CONCLUSIONS
Antihypertensive efficacies of ketanserin and dihydralazine were comparable, but significantly fewer maternal complications were noted among the patients receiving ketanserin. Ketanserin is an attractive alternative in the management of severe early-onset preeclampsia.
Bolte
A C
AC
Divisions of Maternal-Fetal Medicine, Departments of Obstetrics and Gynecology, Free University Hospital, Amsterdam, The Netherlands.
van Eyck
J
J
Kanhai
H H
HH
Bruinse
H W
HW
van Geijn
H P
HP
Dekker
G A
GA
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D004078:Dihydralazine / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D017359:HELLP Syndrome / Q000150:complications; D006801:Humans; D007650:Ketanserin / Q000009:adverse effects / Q000627:therapeutic use*; D009846:Oliguria / Q000150:complications; D010953:Plasma Volume; D011225:Pre-Eclampsia / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000150:complications; D014882:Water-Electrolyte Balance