Methyldopa versus no drug treatment in the management of mild pre-eclampsia.
OBJECTIVE
To evaluate the efficacy of methyldopa in the treatment of mild pre-eclampsia, to prevent its progress and to investigate its effect on the pregnancy outcomes.


METHODS
Randomised clinical trial.


METHODS
Wad Medani Hospital in the central Sudan.


METHODS
Seventy primigravidae with single, alive baby of 28-36 weeks gestational age suffering from true mild pre-eclampsia were enrolled. The patients were randomised in two groups, treatment group who received methyldopa 750-4000 mg/day (n=34) and a control group who received no treatment (n=36). All the (treatment and control) patients were drug followed as in-patients till the delivery, seen with their babies on the days 7, 42 after the delivery.


METHODS
The outcomes examined were, rise of the diastolic blood pressure to 110 mm Hg or more, occurrence of imminent eclampsia or the eclampsia, if the maturity could be achieved, occurrence of intrauterine growth retardation, abruptio placentae, mode of delivery, birth weight, placental weight, perinatal death, Apgar score and referral of the babies to the pediatrician.


RESULTS
Three out of 34 (8.8%) of the treatment group had a rise in the diastolic blood pressure of 110 mm Hg, 18/36 (50%) of the control had a rise in the diastolic blood pressure of 110 mmHg (p < 0.05). Three out of thirty four (8.8%) of the treatment group developed imminent eclampsia, while 10/36 (27.8) of the control group developed imminent eclampsia (p < 0.05). The maturity was achieved in 82.3% and 88.8% of the treatment and the control, respectively (p > 0.05). There were ten (14.2%) perinatal deaths, four of them in the treatment group, while six in the control (p > 0.05). There was no difference regarding birth weight, occurrence of intrauterine growth retardation, placental weight, mode of delivery, Apgar score, referral of the babies to the paediatrician. No patient developed eclampsia or abruptio placenta; there was no maternal death in both groups.


CONCLUSIONS
Methyldopa can prevent the progress of the mild pre-eclampsia to severe pre-eclampsia, without affecting the maturity, birthweight or the neonatal outcomes.
Elhassan
E M
EM
Department of Obstetrics and Gynaecology, University of Gezira, Sudan.
Mirghani
O A
OA
Habour
A B
AB
Adam
I
I
D000037:Abruptio Placentae / Q000209:etiology; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001034:Apgar Score; D001724:Birth Weight; D036861:Delivery, Obstetric / Q000379:methods; D018450:Disease Progression; D004461:Eclampsia / Q000209:etiology; D005260:Female; D005313:Fetal Death / Q000209:etiology; D005317:Fetal Growth Retardation / Q000209:etiology; D006801:Humans; D008750:Methyldopa / Q000627:therapeutic use*; D009929:Organ Size; D010298:Parity; D010372:Pediatrics / Q000706:statistics & numerical data; D010920:Placenta / Q000473:pathology; D011225:Pre-Eclampsia / Q000145:classification / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D008750:Methyldopa