Evidence map›Paper›PMID 29187414›Full record

SynthesisBMJ open2017

Postpartum management of hypertensive disorders of pregnancy: a systematic review.

Alexandra E Cairns, Louise Pealing, James M N Duffy, Nia Roberts, Katherine L Tucker, Paul Leeson, Lucy H MacKillop, Richard J McManus

2 registry-linked trialsOpen access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 31 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 5 pooled it
3.6field-weighted citation impact, top 7% of its field
1 · What the graph read from 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.

2 · The registry

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.

NCT04343235 phase4terminatednot on this mapstarted 2020, after this paper: background citation

Postpartum Management of Gestational Hypertensive Disorders Using Furosemide: A Randomized Controlled Trial

TypeinterventionalSponsorWright State UniversityRan2020 to 2022Enrolled13ConditionsHypertension, Pregnancy-InducedArmsfurosemide, labetalol
NCT04790279 phase4completednot on this mapstarted 2021, after this paper: background citation

Amlodipine Versus Nifedipine ER for the Management of Postpartum Hypertension: A Randomized Controlled Noninferiority Trial

TypeinterventionalSponsorPrisma Health-UpstateRan2021 to 2023Enrolled175ConditionsHypertension in PregnancyArmsAmlodipine, NIFEdipine ER
3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 5 syntheses or guidelines pooled it, 79 citations in OpenAlex.

  1. Pooled it
  2. The Japanese Society of Hypertension Guidelines for the management of elevated blood pressure and hypertension 2025 (JSH2025).Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Guideline
  3. Pooled it
  4. Pooled it
  5. Economic Evaluation of Prenatal and Postpartum Care in Women With Gestational Diabetes and Hypertensive Disorders of Pregnancy: A Systematic Review.Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research · 2022
    Pooled it
  6. Trial
  7. Trial
  8. Article
  9. Observational
  10. Review
  11. Article
  12. Review
  13. Review
  14. Article
  15. Article
  16. Article
  17. Postpartum hypertension-The need for definition and classification.Hypertension research : official journal of the Japanese Society of Hypertension · 2023
    Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Alexandra E CairnsNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0002-6989-0887
Louise PealingNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
James M N DuffyNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Nia RobertsKnowledge Centre, Bodleian Libraries, University of Oxford, Oxford, UK.
Katherine L TuckerNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Paul LeesonCardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford, Oxford, UK.
Lucy H MacKillopNuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK.
Richard J McManusNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.ORCID http://orcid.org/0000-0003-3638-028X
University of Oxford · GB

Funding

British Heart Foundation FS/11/65/28865British Heart Foundation PG/13/58/30397Department of Health DRF-2014-07-051Department of Health NIHR-RP-02-12-015Department of Health RP-PG-0614-20005
6 · The paper itself

Abstract

objectivesHypertensive disorders of pregnancy (HDP) affect one in ten pregnancies and often persist postpartum when complications can occur. We aimed to determine the effectiveness and safety of pharmacological interventions, other interventions and different care models for postpartum hypertension management.

designA systematic review was undertaken. Nine electronic databases, including Medline, were searched from inception to 16 March 2017. After duplicate removal, 4561 records were screened. Two authors independently selected studies, extracted study characteristics and data, and assessed methodological quality.

settingRandomised controlled trials, case-control studies and cohort studies from any country and healthcare setting.

participantsPostnatal women with HDP.

interventionsTherapeutic intervention for management of hypertension, compared with another intervention, placebo or no intervention. PRIMARY AND SECONDARY OUTCOME MEASURES: Outcome data were collected for maternal mortality and severe morbidity; systolic, diastolic and mean arterial blood pressure (BP) control; and safety data. Secondary outcome data collected included the length of postnatal hospital stay and laboratory values.

results39 studies were included (n=2901). Results were heterogeneous in terms of intervention, comparison and outcome requiring a narrative approach. There were insufficient data to recommend any single pharmacological intervention. 18 studies reported calcium-channel blockers, vasodilators and beta-blockers lowered BP postpartum. 12 of these reported safety data. Limited data existed regarding management in the weeks following hospital discharge. Neither loop diuretics (three studies) nor corticosteroids (one study) produced clinical benefit. Uterine curettage significantly reduced BP over the first 48 hours postpartum (range 6-13 mm Hg) compared with standard care (eight studies), with safety data only reported by four of eight studies.

conclusionThere was insufficient evidence to recommend a particular BP threshold, agent or model of care, but three classes of antihypertensive appeared variably effective. Further comparative research, including robust safety data, is required. Curettage reduced BP, but without adequate reporting of harms, so it cannot currently be recommended.

Indexed as

Postpartum PeriodAdrenergic beta-AntagonistsAntihypertensive AgentsCalcium Channel BlockersFemaleHumansHypertension, Pregnancy-InducedPregnancyRandomized Controlled Trials as TopicVasodilator AgentsAdrenergic beta-AntagonistsAntihypertensive AgentsCalcium Channel BlockersVasodilator Agentsantihypertensive medicationgestational hypertensionhypertensive disorders of pregnancypostpartumpreeclampsiasystematic review

Identifiers

PMID29187414
PMCPMC5719299
OpenAlexW2770283433

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.