title: Management of severe hypertension in the postpartum period with intravenous hydralazine or labetalol: a randomized clinical trial.
abstract: OBJECTIVE
  To compare the safety and efficacy of intravenous labetalol and intravenous hydralazine for acutely lowering blood pressure in the puerperium.
  
  
  METHODS
  Randomized clinical trial.
  
  
  METHODS
  Critical care unit of gynecology and obstetrics department in the Complejo hospitalario "Dr. AAM" de la Caja de Seguro Social in Panama.
  
  
  METHODS
  Eighty-two women with severe hypertension during the postpartum period.
  
  
  METHODS
  Patients were randomized to receive hydralazine (5 mg as a slow bolus dose given intravenously, and repeated every 20 minutes to a maximum of five doses) or labetalol (20 mg in an intravenous bolus dose followed by 40 mg if not effective within 20 minutes, followed by 80 mg every 20 minutes to a maximum dose of 300 mg). The primary endpoint was the successful lowering of blood pressure. Secondary endpoints were maternal complications and side-effects.
  
  
  RESULTS
  Forty-two women were enrolled in the hydralazine group and 40 in the labetalol group. Women were similar with respect to characteristics at randomization. No significant differences were observed for persistent severe hypertension or maternal side-effects. There was only one case of persistent severe hypertension in the labetalol group. There were no maternal deaths in any of the women studied.
  
  
  CONCLUSIONS
  This randomized clinical trial shows that intravenous hydralazine and intravenous labetalol are effective and safe in the management of severe hypertension in the postpartum period.
authors.affiliation: Obstetric Intensive Unit, Department of Gynecology and Obstetrics, Complejo Hospitalario "Arnulfo Arias Madrid" Caja de Seguro Social, Panamá, Panamá
authors.forename: Paulino
authors.initials: P
authors.lastname: Vigil-De Gracia
authors.forename: Esteban
authors.initials: E
authors.lastname: Ruiz
authors.forename: Juan C
authors.initials: JC
authors.lastname: López
authors.forename: Ilka Alveo
authors.initials: IA
authors.lastname: de Jaramillo
authors.forename: Juan C
authors.initials: JC
authors.lastname: Vega-Maleck
authors.forename: Jaime
authors.initials: J
authors.lastname: Pinzón
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D006801:Humans; D006830:Hydralazine / Q000008:administration & dosage / Q000627:therapeutic use*; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy* / Q000503:physiopathology; D007262:Infusions, Intravenous; D007741:Labetalol / Q000008:administration & dosage / Q000627:therapeutic use*; D010176:Panama; D049590:Postpartum Period; D012107:Research Design; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D006830:Hydralazine; D007741:Labetalol