SynthesisThe Cochrane database of systematic reviews2000
Drugs for rapid treatment of very high blood pressure during pregnancy.
Synthesis in The Cochrane database of systematic reviews, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed, 5 syntheses or guidelines pooled it, 76 citations in OpenAlex.
- Drugs for treatment of very high blood pressure during pregnancy.The Cochrane database of systematic reviews · 2013Pooled it
- The diagnosis and treatment of hypertensive disorders of pregnancy: new findings for antenatal and inpatient care.Deutsches Arzteblatt international · 2009Pooled it
- Hydralazine for treatment of severe hypertension in pregnancy: meta-analysis.BMJ (Clinical research ed.) · 2003Pooled it
- Oral beta-blockers for mild to moderate hypertension during pregnancy.The Cochrane database of systematic reviews · 2000Pooled it
- Plasma volume expansion for treatment of women with pre-eclampsia.The Cochrane database of systematic reviews · 2000Pooled it
- Management of pre-eclampsia.BMJ (Clinical research ed.) · 2006Review
- Antihypertensive therapy in pregnancy.Current hypertension reports · 2001Review
- Hypertension in pregnancy: new recommendations for management.Current hypertension reports · 1999Article
Corrections and comments
- Updated by
Authors and funding
2 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVery high blood pressure during pregnancy poses a serious threat to women and their fetuses. The use of drugs to lower blood pressure may reduce this risk.
objectivesThe objective of this review was to compare different antihypertensive drugs used for rapid treatment of severe hypertension during pregnancy. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. SELECTION CRITERIA: STUDIES: All randomised trials. Quasi random designs were excluded.
participantsWomen with severe hypertension during pregnancy. Women postpartum at trial entry were excluded.
interventionsComparisons of one antihypertensive agent with another. OUTCOMES: For the women: blood pressure control, eclampsia, serious maternal morbidity (such as kidney failure and liver failure), Caesarean section, and use of health service resources (such as admission to hospital or intensive care unit). For the baby: death, serious neonatal morbidity, infant and child development, and use of health service resources (such as admission to a special care nursery). DATA COLLECTION AND ANALYSIS: Data were extracted independently by two reviewers to assess eligibility and describe the trial characteristics, and by one reviewer for the meta-analyses. Discrepancies were resolved by discussion. There was no blinding of authorship or results. Whenever possible, unpublished data were sought from investigators. MAIN
resultsThirteen of the 14 trials included in this review were small (range 19-627 women). Of the eight comparisons, five included hydralazine. Diazoxide given as 75mg bolus injections appears to be associated with profound hypotension requiring treatment, and ketanserin is less effective than hydralazine at reducing blood pressure. There is no other evidence that any one of the other antihypertensive agents is better than another for women with severe hypertension during pregnancy. REVIEWER'S
conclusionsUntil better evidence is available, the choice of antihypertensive should depend on the experience and familiarity of an individual clinician with a particular drug, and on what is known about adverse maternal and fetal side-effects. Exceptions are diazoxide and ketanserin, which are probably not good choices.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.