Low dose dopamine in postpartum pre-eclamptic women with oliguria: a double-blind, placebo controlled, randomised trial.

OBJECTIVE

To assess the effect of low dose dopamine on the urine output in postpartum pre-eclamptic or eclamptic women with oliguria.

DESIGN

A double blind, randomised controlled study.

SETTING

The high care area of the labour ward in a teaching hospital.

SAMPLE

Forty postpartum pre-eclamptic women with oliguria, defined as < 30 mL/hour, who have not responded to a 300 mL crystalloid fluid challenge.

INTERVENTION

Dopamine was infused at a rate of 1 to 5 microg/kg per minute, or sterile water was given as placebo in the same dilution.

MAIN OUTCOME MEASURE

Urine output, blood pressure and pulse was measured for six hours before and for six hours after the intervention.

RESULTS

Women who received dopamine (344 mL over 6 hours) showed a clinically and statistically significant (P = 0.0014, Mann-Whitney U test) higher median urine output compared with those receiving placebo (135 mL over 6 hours) for the duration of therapy. The respective 95% confidence intervals were 212.3 to 712.7 mL compared with 73.8 to 244.7 mL. No differences in blood pressure or pulse were found between the two groups.

CONCLUSIONS

The use of low dose dopamine in a labour setting improved urine output in postpartum pre-eclamptic women with oliguria who had not responded to a single fluid challenge without a detrimental effect on the blood pressure or pulse.