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高血圧緊急症

関連論文:
img  6:  Severe hypertension in pregnancy: hydralazine or labetalol. A randomized clinical trial.
 
著者: Paulino Vigil-De Gracia, Martin Lasso, Esteban Ruiz, Juan Carlos Vega-Malek, Flor Tem de Mena, Juan Carlos López, or the HYLA treatment study
雑誌名: Eur J Obstet Gynecol Reprod Biol. 2006 Sep-Oct;128(1-2):157-62. doi: 10.1016/j.ejogrb.2006.02.015. Epub 2006 Apr 18.
Abstract/Text OBJECTIVE: The objective was to compare the safety and efficacy of intravenous labetalol and intravenous hydralazine for acutely lowering blood pressure in pregnancy.
STUDY DESIGN: Two hundred women with severe hypertension in pregnancy were randomized to receive hydralazine (5 mg as a slow bolus dose given intravenously, and repeated every 20 min up to a maximum of five doses) or labetalol (20-mg intravenous bolus dose followed by 40 mg if not effective within 20 min, followed by 80 mg every 20 min up to a maximum dose of 300 mg). The primary end point was successful lowering of blood pressure and maternal hypotension.
RESULTS: Women were similar with respect to characteristics at randomization. No significant differences were observed for maternal hypotension or persistent severe hypertension; only two patients in the hydralazine group presented with hypotension. Palpitations (p=0.01) and maternal tachycardia (p=0.05) occurred significantly more often in patients treated with hydralazine. The main neonatal outcomes were very similar per group; however, hypotension and bradycardia were significantly more frequent in the labetalol group. There were two neonatal deaths per antihypertensive drug group.
CONCLUSIONS: This randomized clinical trial shows that labetalol and hydralazine fulfill the criteria required for an antihypertensive drug to treat severe hypertension in pregnancy.

PMID 16621226  Eur J Obstet Gynecol Reprod Biol. 2006 Sep-Oct;128(1-2):157-62. doi: 10.1016/j.ejogrb.2006.02.015. Epub 2006 Apr 18.
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