Ngene Nnabuike Chibuoke, Moodley Jagidesa
Department of Obstetrics and Gynaecology, University of KwaZulu-Natal, Durban, South Africa.
Department of Obstetrics and Gynaecology, Klerksdorp Hospital, North West Province, Klerksdorp, South Africa.
Pan Afr Med J. 2020 Jul 27;36:216. doi: 10.11604/pamj.2020.36.216.19895. eCollection 2020.
there is variance in both the types and combinations of antihypertensive drugs used for managing pre-eclampsia in the postpartum period. Knowledge of the most common and suitable single or combination antihypertensive drug therapies in the postpartum period will minimize harmful effects, promote adherence to medications, overcome any fears that lactating mothers may have about these drugs and will assist in healthcare planning. Objective: to determine the types of antihypertensive drug therapies used in managing pre-eclampsia with severe features (sPE) in the postpartum period in a regional hospital in South Africa.
fifty consecutively presenting pregnant women with sPE were followed up prospectively from the pre-delivery period (within 48 hours before delivery) until day 3 postpartum. The antihypertensive drug therapies administered to the participants were observed. Their blood pressures were measured daily at 04: 00, 08: 00, 14: 00 and 22: 00 hours.
nifedipine was the commonest rapid-acting agent used for severe hypertension. Prepartum, 9 different combinations of antihypertensive drugs were prescribed; alpha-methyldopa was the commonest single long-acting agent used. Postpartum, the number of different drug combinations administered were 15, 18, 22 and 16 on days 0, 1, 2 and 3 respectively. Alpha-methyldopa was the commonest single agent used on postpartum days 0 - 2 while hydrochlorothiazide was the most frequently used single agent on postpartum day 3. Postpartum, the commonest combination therapy was alpha-methyldopa and amlodipine on day 0; alpha-methyldopa and amlodipine as a regimen as well as alpha-methyldopa, amlodipine and hydrochlorothiazide as another regimen on day 1; alpha-methyldopa and amlodipine on day 2; and many amlodipine-based regimens on day 3.
a variety of antihypertensive drug combinations were used in the postpartum period indicating the need for standardised guidelines; however, detailed studies are required to evaluate their efficacies completely.
用于产后子痫前期管理的降压药物的类型和组合存在差异。了解产后最常见且合适的单一或联合降压药物治疗方法将减少有害影响，促进药物依从性，消除哺乳期母亲对这些药物可能存在的任何担忧，并有助于医疗保健规划。目的：确定南非一家地区医院产后用于管理重度子痫前期（sPE）的降压药物治疗类型。
对50例连续就诊的患有sPE的孕妇进行前瞻性随访，从分娩前期（分娩前48小时内）直至产后第3天。观察给予参与者的降压药物治疗方法。每天在04:00、08:00、14:00和22:00测量她们的血压。
硝苯地平是用于重度高血压的最常见速效药物。产前，开具了9种不同的降压药物组合；α-甲基多巴是最常用的单一长效药物。产后，在第0、1、2和3天分别给予了15、18、22和16种不同的药物组合。产后第0 - 2天最常用的单一药物是α-甲基多巴，而产后第3天最常用的单一药物是氢氯噻嗪。产后，最常见的联合治疗方案在第0天是α-甲基多巴和氨氯地平；在第1天是α-甲基多巴和氨氯地平作为一种方案以及α-甲基多巴、氨氯地平和氢氯噻嗪作为另一种方案；在第2天是α-甲基多巴和氨氯地平；在第3天是许多基于氨氯地平的方案。
产后使用了多种降压药物组合，这表明需要标准化指南；然而，需要进行详细研究以全面评估它们的疗效。
