Postpartum preeclampsia management with furosemide: a randomized clinical trial.
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.


CONCLUSIONS
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.
Ascarelli
Marian H
MH
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi 39216, USA.
Johnson
Venessia
V
McCreary
Holly
H
Cushman
Julie
J
May
Warren L
WL
Martin
James N
JN
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D004231:Diuresis; D004232:Diuretics / Q000627:therapeutic use*; D005260:Female; D005665:Furosemide / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D049590:Postpartum Period; D011225:Pre-Eclampsia / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy
D000959:Antihypertensive Agents; D004232:Diuretics; D005665:Furosemide