| A randomised controlled trial comparing two temporising management strategies, one with and one without plasma volume expansion, for severe and early onset pre-eclampsia. | |
MedLine Citation:
|
PMID: 16167938 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: Plasma volume expansion may benefit both mother and child in the temporising management of severe and early onset hypertensive disorders of pregnancy. DESIGN: Randomised clinical trial. Setting Two university hospitals in Amsterdam, The Netherlands. POPULATION: Two hundred and sixteen patients with a gestational age between 24 and 34 completed weeks with severe pre-eclampsia, haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome or severe fetal growth restriction (FGR) with pregnancy-induced hypertension, admitted between 1 April 2000 and 31 May 2003. METHODS: One hundred and eleven patients were randomly allocated to the treatment group, (plasma volume expansion and a diastolic BP target of 85-95 mmHg) and 105 to the control group (intravenous fluid restriction and BP target of 95-105 mmHg). MAIN OUTCOME MEASURES: Neonatal neurological development at term age (Prechtl score), perinatal death, neonatal morbidity and maternal morbidity. RESULTS: Baseline characteristics were comparable between groups. The median gestational age was 30 weeks. In the treatment group, patients received higher amounts of intravenous fluids (median 813 mL/day vs 14 mL/day; P < 0.001) with a concomitant decreased haemoglobin count (median -0.6 vs-0.2 mmol/L; P < 0.001). Neither neurological scores nor composite neonatal morbidity differed. A trend towards less prolongation of pregnancy (median 7.4 vs 11.5 days; P= 0.054) and more infants requiring oxygen treatment >21% (66 vs 46; P= 0.09) in the treatment group was observed. There was no difference in major maternal morbidity (total 11%), but there were more caesarean sections in the treatment group (98%vs 90%; P < 0.05). CONCLUSION: The addition of plasma volume expansion in temporising treatment does not improve maternal or fetal outcome in women with early preterm hypertensive complications of pregnancy. |
Authors:
|
Wessel Ganzevoort; Annelies Rep; Gouke J Bonsel; Willem P F Fetter; Loekie van Sonderen; Johanna I P De Vries; Hans Wolf; |
Related Documents
:
|
3679448 - The possible role of digitalislike factors in pregnancy-induced hypertension. 17519778 - Pregnancy after organ transplantation: a report from the uk transplant pregnancy registry. 2794958 - Hypertensive disorders in pregnancy: analysis of 110 cases. 675128 - Plasmatic level of angiotensin i in normal subjects of various ages, in cushing's syndr... 7123828 - Effect of progesterone treatment on the calving-to-conception interval of friesian dair... 8839628 - Plasma bovine placental lactogen concentration throughout pregnancy in the cow; relatio... |
Publication Detail:
|
Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: BJOG : an international journal of obstetrics and gynaecology Volume: 112 ISSN: 1470-0328 ISO Abbreviation: BJOG Publication Date: 2005 Oct |
Date Detail:
|
Created Date: 2005-09-19 Completed Date: 2005-12-05 Revised Date: 2014-07-29 |
Medline Journal Info:
|
Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
|
Languages: eng Pagination: 1358-68 Citation Subset: AIM; IM |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Antihypertensive Agents / therapeutic use* Blood Pressure / physiology Body Weight Female Fluid Therapy / methods Humans Hydroxyethyl Starch Derivatives / therapeutic use Plasma Substitutes / therapeutic use* Pre-Eclampsia / therapy* Pregnancy Pregnancy Outcome |
| Chemical | |
Reg. No./Substance:
|
0/Antihypertensive Agents; 0/Hydroxyethyl Starch Derivatives; 0/Plasma Substitutes |
| Comments/Corrections | |
Comment In:
|
BJOG. 2005 Oct;112(10):1337-8
[PMID:
16167934
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: A population-based study of the prenatal diagnosis of congenital malformation over 16 years.
Next Document: The future of prenatal diagnosis: rapid testing or full karyotype? An audit of chromosome abnormalit...