Bolte A C, van Eyck J, Gaffar S F, van Geijn H P, Dekker G A
Department of Obstetrics and Gynecology, Free University Hospital, Amsterdam, The Netherlands.
J Perinat Med. 2001;29(1):14-22. doi: 10.1515/JPM.2001.002.
To compare maternal and perinatal outcome with the use of either intravenous ketanserin or dihydralazine in treatment of women with preeclampsia.
The records from January 1989 to January 1997 of all patients receiving intravenous ketanserin or dihydralazine as first line antihypertensive therapy were reviewed and standardized data forms were completed. 315 charts of patients were identified and evaluated for effects on blood pressure, laboratory parameters, maternal and perinatal outcome.
During the study interval 169 patients received ketanserin and 146 dihydralazine. Significantly fewer antepartum (27% versus 38%, p = 0.04) and postpartum (25% versus 39%, p = 0.01) maternal complications were noted in patients receiving ketanserin. Occurrence of HELLP syndrome was significantly lower among patients who received ketanserin (20%) than among those who received dihydralazine (40%, p = 0.0001). Side-effects were reported with significantly higher frequency in patients receiving dihydralazine (60%) as compared to those receiving ketanserin (17%, p < 0.0001). Perinatal outcome was comparable, however, umbilical cord arterial pH values (mean +/- SD) were higher with ketanserin compared to dihydralazine (7.25 +/- 0.07 vs 7.23 +/- 0.09, p = 0.038). The incidence of placental abruption was higher in patients receiving dihydralazine (5.5%) versus those receiving ketanserin (0.6%, p = 0.014).
Ketanserin appears to be a better option than dihydralazine for treatment of severe preeclampsia since fewer maternal complications and side-effects were observed in patients receiving ketanserin.
比较静脉注射酮色林或双肼屈嗪治疗子痫前期女性患者时的孕产妇及围产期结局。
回顾1989年1月至1997年1月期间所有接受静脉注射酮色林或双肼屈嗪作为一线降压治疗的患者记录，并填写标准化数据表格。确定并评估315例患者的病历，以观察其对血压、实验室指标、孕产妇及围产期结局的影响。
在研究期间，169例患者接受了酮色林治疗，146例接受了双肼屈嗪治疗。接受酮色林治疗的患者产前（27% 对38%，p = 0.04）和产后（25% 对39%，p = 0.01）孕产妇并发症显著减少。接受酮色林治疗的患者中HELLP综合征的发生率（20%）显著低于接受双肼屈嗪治疗的患者（40%，p = 0.0001）。与接受酮色林治疗的患者（17%）相比，接受双肼屈嗪治疗的患者（60%）报告的副作用频率显著更高（p < 0.0001）。围产期结局相当，然而，与双肼屈嗪相比，酮色林治疗的患者脐动脉pH值（均值±标准差）更高（7.25±0.07对7.23±0.09，p = 0.038）。接受双肼屈嗪治疗的患者胎盘早剥发生率（5.5%）高于接受酮色林治疗的患者（0.6%，p = 0.014）。
对于重度子痫前期的治疗，酮色林似乎是比双肼屈嗪更好的选择，因为接受酮色林治疗的患者孕产妇并发症和副作用更少。
