| 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:
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PMID: 16167938 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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:
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Wessel Ganzevoort; Annelies Rep; Gouke J Bonsel; Willem P F Fetter; Loekie van Sonderen; Johanna I P De Vries; Hans Wolf; |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: BJOG : an international journal of obstetrics and gynaecology Volume: 112 ISSN: 1470-0328 ISO Abbreviation: BJOG Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-09-19 Completed Date: 2005-12-05 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 100935741 Medline TA: BJOG Country: England |
Other Details:
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Languages: eng Pagination: 1358-68 Citation Subset: AIM; IM |
Affiliation:
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Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Antihypertensive Agents / therapeutic use* Blood Pressure / physiology Body Weight Female Fluid Therapy / methods Hetastarch / therapeutic use Humans Plasma Substitutes / therapeutic use* Pre-Eclampsia / therapy* Pregnancy Pregnancy Outcome |
| Chemical | |
Reg. No./Substance:
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0/Antihypertensive Agents; 0/Plasma Substitutes; 9005-27-0/Hetastarch |
| Comments/Corrections | |
Comment In:
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BJOG. 2005 Oct;112(10):1337-8
[PMID:
16167934
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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