title: Diuretics vs. placebo for postpartum blood pressure control in preeclampsia (DIUPRE): a randomized clinical trial.
abstract: BACKGROUND
  Hypertension affects about 10% of pregnancies and is responsible for both maternal and neonatal devastating complications such as eclampsia, HELLP syndrome, prematurity and maternal and neonatal death. The resolution of the disease occurs in the first twelve weeks postpartum. The behavior of blood pressure and occurrence of very high blood pressure episodes among women with severe preeclampsia is related to remodeling of the dynamics of body fluids with consequent increase in intravascular volume. The persistence of hypertension in critical levels results in increased puerperal morbidity.
  
  
  OBJECTIVE
  To evaluate the effectiveness of furosemide in accelerating blood pressure recovery among women with severe preeclampsia.
  
  
  METHODS
  A triple-masked placebo controlled clinical trial, will be conducted including 120 postpartum women with severe preeclampsia, after eclampsia prophylaxis with magnesium sulfate and with adequate diuresis. Women with chronic hypertension and users of diuretics will be deleted. Informed consent will be obtained from all participants. Patients will be randomized to receive furosemide (40 mg orally every twenty four hours) or placebo. The variables are systolic and diastolic blood pressure, frequency of hypertensive crises, need for maintenance of antihypertensive therapy, number of antihypertensive agents used to control blood pressure, urine output, length of hospital stay, adverse effects and maternal complications. This study was approved by the Research Ethics Committee in humans of our institution. All participants will be duly informed about the aims of the project and will be included only if they agree to participate voluntarily, signing the informed consent.
  
  
  BACKGROUND
  This study was registered on Clinical Trials.gov under the number NCT02163655. ( http://clinicaltrials.gov/show/NCT02163655).
authors.affiliation: Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil. macursino5.2@gmail.com.
authors.forename: Telma
authors.initials: T
authors.lastname: Cursino
authors.affiliation: Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil. katzleila@gmail.com.
authors.forename: Leila
authors.initials: L
authors.lastname: Katz
authors.affiliation: Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil. isabelacoutinhoneiva@gmail.com.
authors.forename: Isabela
authors.initials: I
authors.lastname: Coutinho
authors.affiliation: Instituto de Medicina Integral Prof. Fernando Figueira, Recife, PE, Brazil. melania.amorim@gmail.com.|Department of Obstetrics and Gynecology, Federal University of Campina Grande, Campina Grande, PB, Brazil. melania.amorim@gmail.com.
authors.forename: Melania
authors.initials: M
authors.lastname: Amorim
mesh_terms: D001794:Blood Pressure; D004232:Diuretics / Q000627:therapeutic use*; D004461:Eclampsia / Q000517:prevention & control; D005260:Female; D005665:Furosemide / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007902:Length of Stay; D008278:Magnesium Sulfate / Q000627:therapeutic use; D010919:Placebos; D011225:Pre-Eclampsia / Q000188:drug therapy* / Q000503:physiopathology; D011247:Pregnancy; D011644:Puerperal Disorders / Q000188:drug therapy*
chemical_list: D004232:Diuretics; D010919:Placebos; D008278:Magnesium Sulfate; D005665:Furosemide