title: Impedance cardiography assessed treatment of acute severe pregnancy hypertension: a randomized trial.
abstract: OBJECTIVE
  Using noninvasive bedside impedance cardiography (ICG), we compared the effectiveness and the hemodynamic impact of intravenous labetalol versus hydralazine for the reduction of acute-onset severe hypertension to ACOG-recommended blood pressure levels (ACOG Committee Opinion 514).
  
  
  METHODS
  In this prospective randomized pilot study of acutely severe systolic hypertension (≥160 mmHg), pregnant women received either labetalol (L) or hydralazine (H) intravenously and underwent thoracic ICG before and after treatment. Data analysis were performed using STATA software (StataCorp LP, College Station, TX); data are expressed as mean ± SD.
  
  
  RESULTS
  About 29 patients completed the study. There was no significant difference in mean arterial pressure (MAP) between groups [H = 119.4 mmHg, L = 117.7 mmHg, mean difference (MD) = 1.73); the estimated MD between baseline and follow-up ICG was -9.17 (p = 0.001, 95% CI: -14.39 to -3.95). There were no significant differences in total peripheral resistance (TPR) between groups (H = 1771.3, L = 1976.97, MD = 205.62) or cardiac output (CO) between groups (H = 5.7, L = 5.1, MD = 0.64) or a significant MD between these at baseline and follow-up.
  
  
  CONCLUSIONS
  Both drugs performed similarly to achieve ACOG-recommended initial blood pressure reduction safely without side effects or excessive acute hemodynamic profile correction toward normal pregnancy values.
authors.affiliation: a Divisions of Maternal-Fetal Medicine and Biostatistics, Department of Obstetrics and Gynecology , University of Mississippi Medical Center (UMMC) , Jackson , MS , USA.
authors.forename: Rachael
authors.initials: R
authors.lastname: Morris
authors.affiliation: a Divisions of Maternal-Fetal Medicine and Biostatistics, Department of Obstetrics and Gynecology , University of Mississippi Medical Center (UMMC) , Jackson , MS , USA.
authors.forename: Imran
authors.initials: I
authors.lastname: Sunesara
authors.affiliation: a Divisions of Maternal-Fetal Medicine and Biostatistics, Department of Obstetrics and Gynecology , University of Mississippi Medical Center (UMMC) , Jackson , MS , USA.
authors.forename: Marie
authors.initials: M
authors.lastname: Darby
authors.affiliation: a Divisions of Maternal-Fetal Medicine and Biostatistics, Department of Obstetrics and Gynecology , University of Mississippi Medical Center (UMMC) , Jackson , MS , USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Novotny
authors.affiliation: a Divisions of Maternal-Fetal Medicine and Biostatistics, Department of Obstetrics and Gynecology , University of Mississippi Medical Center (UMMC) , Jackson , MS , USA.
authors.forename: Luissa
authors.initials: L
authors.lastname: Kiprono
authors.affiliation: a Divisions of Maternal-Fetal Medicine and Biostatistics, Department of Obstetrics and Gynecology , University of Mississippi Medical Center (UMMC) , Jackson , MS , USA.
authors.forename: Leody
authors.initials: L
authors.lastname: Bautista
authors.affiliation: a Divisions of Maternal-Fetal Medicine and Biostatistics, Department of Obstetrics and Gynecology , University of Mississippi Medical Center (UMMC) , Jackson , MS , USA.
authors.forename: Sandip
authors.initials: S
authors.lastname: Sawardecker
authors.affiliation: a Divisions of Maternal-Fetal Medicine and Biostatistics, Department of Obstetrics and Gynecology , University of Mississippi Medical Center (UMMC) , Jackson , MS , USA.
authors.forename: James
authors.initials: J
authors.lastname: Bofill
authors.affiliation: a Divisions of Maternal-Fetal Medicine and Biostatistics, Department of Obstetrics and Gynecology , University of Mississippi Medical Center (UMMC) , Jackson , MS , USA.
authors.forename: Belinda
authors.initials: B
authors.lastname: Anderson
authors.affiliation: a Divisions of Maternal-Fetal Medicine and Biostatistics, Department of Obstetrics and Gynecology , University of Mississippi Medical Center (UMMC) , Jackson , MS , USA.
authors.forename: James N
authors.initials: JN
authors.lastname: Martin
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002302:Cardiac Output / Q000187:drug effects; D002307:Cardiography, Impedance; D005260:Female; D006801:Humans; D006830:Hydralazine / Q000494:pharmacology / Q000627:therapeutic use*; D046110:Hypertension, Pregnancy-Induced / Q000188:drug therapy*; D007231:Infant, Newborn; D007741:Labetalol / Q000494:pharmacology / Q000627:therapeutic use*; D010865:Pilot Projects; D011247:Pregnancy; D011446:Prospective Studies; D014655:Vascular Resistance / Q000187:drug effects; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D006830:Hydralazine; D007741:Labetalol
keywords: Hemodynamics; ICG; hypertension