Ketanserin in women with chronic hypertension and underlying thrombophilia.
BACKGROUND
Pregnant women with chronic hypertension and thrombophilia have an increased risk for preeclampsia and/or intrauterine growth restriction (IUGR). Ketanserin lowers blood pressure and inhibits serotonin-induced platelet aggregation.


METHODS
A 38-year-old woman with chronic hypertension had a first pregnancy with severe hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. A second pregnancy with prophylactic oral ketanserin and low-dose aspirin was uneventful. The third pregnancy without oral ketanserin was again complicated by severe superimposed preeclampsia and IUGR. During this pregnancy a prothrombin mutation was found. A 37-year-old woman with chronic hypertension developed severe early-onset superimposed preeclampsia in her first pregnancy. In the 3 consecutive pregnancies, she was treated with low-molecular-weight heparin because of a factor XII deficiency. Only the pregnancy with the use of prophylactic oral ketanserin was uncomplicated.


CONCLUSIONS
Clinical trials are warranted to analyze the role of oral ketanserin in preventing preeclampsia and IUGR.
Banga
Franyke R
FR
Department of Obstetrics and Gynecology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.
Bolte
Antoinette C
AC
Dekker
Gustaaf A
GA
van Geijn
Herman P
HP
D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005317:Fetal Growth Retardation / Q000517:prevention & control; D017359:HELLP Syndrome / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007650:Ketanserin / Q000008:administration & dosage / Q000627:therapeutic use*; D011225:Pre-Eclampsia / Q000517:prevention & control; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D019851:Thrombophilia / Q000188:drug therapy*
D000959:Antihypertensive Agents; D007650:Ketanserin