Philadelphia: A short-course of furosemide after childbirth may significantly improve BP control in women with hypertensive disorders of pregnancy (HDP), specifically in women without severe disease.
Persistent postpartum hypertension is a significant cause of morbidity in mothers. Joana Lopes Perdigao, University of Pennsylvania, University of Pennsylvania Perelman School of Medicine, Philadelphia, and colleagues aimed to study the effect of furosemide on postpartum blood pressure recovery in women with HDP.
For the purpose, the researchers performed a randomized, double-blind, placebo-controlled trial. The trial was of a 5-day course of 20 mg oral furosemide versus placebo in women with gestational hypertension and preeclampsia with/without severe features from June 2018 to October 2019.
Primary outcomes were persistent hypertension at 7 days postpartum and days to resolution of hypertension, stratified by severe/nonsevere hypertensive disease. Secondary outcomes included readmissions and need for additional hypertensive medication.
The study included 384 women (192 were randomized to each group).
Key findings of the study include:
Baseline characteristics were similar except cesarean delivery rate was higher in the furosemide group (29% versus 20%).
In women randomized to furosemide, there was a 60% reduction in the prevalence of persistently elevated blood pressure at 7 days when controlling for cesarean (adjusted relative risk, 0.40).
The magnitude of reduction was greater in women with nonsevere disease (adjusted relative risk, 0.26).
Number of days to blood pressure resolution was significantly shorter among women with nonsevere disease randomized to furosemide (8.5 versus 10.5).
There were no significant differences in readmissions or need for additional antihypertensive medication postpartum between groups.
"In this double-blinded randomized trial, a short course of postpartum furosemide significantly improved blood pressure control in women with hypertensive disorders of pregnancy, mostly among women without severe disease," concluded the authors.
The study titled, "Furosemide for Accelerated Recovery of Blood Pressure Postpartum in women with a hypertensive disorder of pregnancy: A Randomized Controlled Trial," is published in the AHA journal Hypertension.
DOI: https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.16133