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This randomized controlled trial determined the efficacy of furosemide (fast-acting diuretic) versus placebo in managing postpartum blood pressure in women with severe preeclampsia.
Oral furosemide (40 mg/day) effectively reduces postpartum hypertension and accelerates blood pressure normalization in severe preeclampsia.
This randomized controlled trial determined the efficacy of furosemide (fast-acting diuretic) versus placebo in managing postpartum blood pressure in women with severe preeclampsia.
Postpartum women diagnosed with de novo severe preeclampsia or eclampsia during pregnancy who had adequate diuresis and had received magnesium sulfate were included. Volunteers were randomly assigned to get either oral furosemide (40 mg/day for five days) or placebo. The key endpoint measured was mean blood pressure levels.
The secondary endpoints encompassed hospital stay duration, adverse effects, maternal complications, incidence of severe hypertension, sustained reliance on antihypertensives, and number of antihypertensive agents required. A sample size of 120 women (60 per group) was estimated based on an expected difference in mean systolic pressure: 142±12 mmHg in the furosemide group versus 153±19 mmHg in the placebo group.
In total, 271 volunteers were screened, and 120 were randomly segregated into either the furosemide or placebo group. Overall, 118 volunteers (58 furosemide, 60 placebo) were included in the final analysis, with baseline characteristics being comparable between groups. The furosemide group illustrated markedly lower mean daily systolic and diastolic blood pressure (P<0.001), along with fewer severe hypertensive episodes on the second (P=0.04) and fifth (P=0.04) days. Additionally, blood pressure normalization was attained more rapidly in the furosemide group (P=0.01).
In postpartum women with preeclampsia, a daily dose of 40 mg oral furosemide successfully reduced mean daily systolic blood pressure on days 1 and 5, as well as mean daily diastolic blood pressure on days 1, 2, and 5. Furosemide also shortened the time needed to attain blood pressure control.
American Journal of Obstetrics & Gynecology MFM
Postpartum furosemide for accelerating recovery in patients with preeclampsia: A Randomized Placebo-Controlled Trial: Furosemide for postpartum hypertension
Telma Cursino et al.
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