A randomized trial of tight vs. less tight control of mild essential and gestational hypertension in pregnancy
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Alaa A. El Guindy
Abstract
Objectives: To assess the effects of applying a tight vs. a less tight control of mild chronic essential or gestational non-proteinuric hypertension in pregnancy.
Methods: A randomized trial was conducted in 2006–2007 in the University of Ain Shams, Egypt. Eligible participants (n=125) were randomly assigned to either tight or less tight control of mild chronic (essential) or gestational (non-proteinuric) hypertension. The primary outcome measure was the development of severe hypertension during follow-up. Analysis was by intention-to-treat.
Results: In the tight target group, adjustment of the dose with an increment of 191 mg yielded a mean dose of methyldopa of 1267±406 mg. Both systolic and diastolic BP levels were significantly less than in the tight target group. More women in the less tight group had severe hypertension during follow up (RR 3.167 and 95% CI 1.36–7.37). The rate of antenatal hospitalization was significantly higher in the less tight target group with a relative risk of 2.57 and 95% CI 1.16–5.70. The gestational age at delivery was significantly better in the tight target group. Preterm delivery and birth weight were not significantly different between the study groups.
Conclusion: Tight control of blood pressure reduces the rate of antenatal hospitalization and does not adversely affect perinatal outcomes in women with mild essential or gestational hypertension.
©2008 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Original articles – Obstetrics
- Premature labor: a state of platelet activation?
- Soluble receptor for advanced glycation end products (sRAGE) and endogenous secretory RAGE (esRAGE) in amniotic fluid: modulation by infection and inflammation
- Detection of feto-maternal infection/inflammation by the soluble receptor for advanced glycation end products (sRAGE): results of a pilot study
- Weight gain in pregnancy according to maternal height and weight
- A randomized trial of tight vs. less tight control of mild essential and gestational hypertension in pregnancy
- Pregnancy outcome of women who developed proteinuria in the absence of hypertension after mid-gestation
- Anxiety symptoms during late pregnancy and early parenthood following assisted reproductive technology
- Original article – Fetus
- Human fetal heart rate variability-characteristics of autonomic regulation in the third trimester of gestation
- Original articles – Newborn
- Bronchopulmonary dysplasia and early prophylactic inhaled nitric oxide in preterm infants: current concepts and future research strategies in animal models
- Side effects of angiotensin converting enzyme inhibitor (captopril) in newborns and young infants
- Letters to the editor
- Mirror syndrome due to coxackie B virus associated to maternal peripartum cardiomyopathy
- Non-cardiogenic lung edema in a woman treated with atosiban for preterm labor
- Commentary: A case of non-cardiogenic lung edema in a woman treated with atosiban for preterm labor
- Congress Calendar
- 10.1515/JPM.2008.095
- Erratum
- Total body water in small- and appropriate - for gestational age newborns
- Announcement
- Calling European Pediatric Research Networks
- WAPM-Newsletter
- WAPM-Newsletter No 1/2008
