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Meta-Analysis
. 2013 Jul 31;2013(7):CD001449.
doi: 10.1002/14651858.CD001449.pub3.

Drugs for treatment of very high blood pressure during pregnancy

Lelia Duley  1 , Shireen Meher, Leanne Jones
Affiliations
Meta-Analysis

Drugs for treatment of very high blood pressure during pregnancy

Lelia Duley et al. Cochrane Database Syst Rev. .

Abstract

Background: Very high blood pressure during pregnancy poses a serious threat to women and their babies. The aim of antihypertensive therapy is to lower blood pressure quickly but safety, to avoid complications. Antihypertensive drugs lower blood pressure but their comparative effectiveness and safety, and impact on other substantive outcomes is uncertain.

Objectives: To compare different antihypertensive drugs for very high blood pressure during pregnancy.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (9 January 2013).

Selection criteria: Studies were randomised trials. Participants were women with severe hypertension during pregnancy. Interventions were comparisons of one antihypertensive drug with another.

Data collection and analysis: Two review authors independently assessed trials for inclusion and assessed trial quality. Two review authors extracted data and checked them for accuracy.

Main results: Thirty-five trials (3573 women) with 15 comparisons were included. Women allocated calcium channel blockers were less likely to have persistent high blood pressure compared to those allocated hydralazine (six trials, 313 women; 8% versus 22%; risk ratio (RR) 0.37, 95% confidence interval (CI) 0.21 to 0.66). Ketanserin was associated with more persistent high blood pressure than hydralazine (three trials, 180 women; 27% versus 6%; RR 4.79, 95% CI 1.95 to 11.73), but fewer side-effects (three trials, 120 women; RR 0.32, 95% CI 0.19 to 0.53) and a lower risk of HELLP (haemolysis, elevated liver enzymes and lowered platelets) syndrome (one trial, 44 women; RR 0.20, 95% CI 0.05 to 0.81).Labetalol was associated with a lower risk of hypotension compared to diazoxide (one trial 90 women; RR 0.06, 95% CI 0.00 to 0.99) and a lower risk of caesarean section (RR 0.43, 95% CI 0.18 to 1.02), although both were borderline for statistical significance.Both nimodipine and magnesium sulphate were associated with a high incidence of persistent high blood pressure, but this risk was lower for nimodipine compared to magnesium sulphate (one trial, 1650 women; 47% versus 65%; RR 0.84, 95% CI 0.76 to 0.93). Nimodipine was associated with a lower risk of respiratory difficulties (RR 0.28, 95% CI 0.08 to 0.99), fewer side-effects (RR 0.68, 95% CI 0.55 to 0.85) and less postpartum haemorrhage (RR 0.41, 95% CI 0.18 to 0.92) than magnesium sulphate. Stillbirths and neonatal deaths were not reported.There are insufficient data for reliable conclusions about the comparative effects of any other drugs.

Authors' conclusions: Until better evidence is available the choice of antihypertensive should depend on the clinician's experience and familiarity with a particular drug; on what is known about adverse effects; and on women's preferences. Exceptions are nimodipine, magnesium sulphate (although this is indicated for women who require an anticonvulsant for prevention or treatment of eclampsia), diazoxide and ketanserin, which are probably best avoided.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
2
2
'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 1 Maternal deaths.
1.2
1.2. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 2 Eclampsia.
1.3
1.3. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 3 Persistent high blood pressure.
1.4
1.4. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 4 Fetal or neonatal deaths.
1.5
1.5. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 5 HELLP syndrome.
1.6
1.6. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 6 Serious morbidity for woman: oliguria.
1.7
1.7. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 7 Serious morbidity for woman: disseminated intravascular coagulation.
1.8
1.8. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 8 Serious morbidity for woman: acute renal insufficiency.
1.9
1.9. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 9 Serious morbidity for woman: pulmonary oedema.
1.10
1.10. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 10 Hypotension.
1.11
1.11. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 11 Side‐effects for the woman.
1.12
1.12. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 12 Placental abruption.
1.13
1.13. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 13 Caesarean section.
1.14
1.14. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 14 Respiratory distress syndrome.
1.15
1.15. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 15 Necrotizinc enterocolitis.
1.16
1.16. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 16 Intraventricular haemorrhage.
1.17
1.17. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 17 Apgar < 7 at 1 minute.
1.18
1.18. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 18 Apgar < 7 at 5 minutes.
1.19
1.19. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 19 Fetal heart rate decelerations.
1.20
1.20. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 20 Neonatal hypoglycaemia.
1.21
1.21. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 21 Admission to special care baby unit.
1.22
1.22. Analysis
Comparison 1 Labetalol versus hydralazine, Outcome 22 Neonate with complications (some neonates had more than one complication)..
2.1
2.1. Analysis
Comparison 2 Calcium channel blockers versus hydralazine, Outcome 1 Persistent high blood pressure.
2.2
2.2. Analysis
Comparison 2 Calcium channel blockers versus hydralazine, Outcome 2 Hypotension.
2.3
2.3. Analysis
Comparison 2 Calcium channel blockers versus hydralazine, Outcome 3 Further episode/s of very high blood pressure.
2.4
2.4. Analysis
Comparison 2 Calcium channel blockers versus hydralazine, Outcome 4 Side‐effects for the woman.
2.5
2.5. Analysis
Comparison 2 Calcium channel blockers versus hydralazine, Outcome 5 Side‐effects for the woman (specific effects).
2.6
2.6. Analysis
Comparison 2 Calcium channel blockers versus hydralazine, Outcome 6 Caesarean section.
2.7
2.7. Analysis
Comparison 2 Calcium channel blockers versus hydralazine, Outcome 7 Fetal or neonatal death.
2.8
2.8. Analysis
Comparison 2 Calcium channel blockers versus hydralazine, Outcome 8 Apgar < 7 at 5 minutes.
2.9
2.9. Analysis
Comparison 2 Calcium channel blockers versus hydralazine, Outcome 9 Fetal heart rate decelerations.
3.1
3.1. Analysis
Comparison 3 Prostacyclin versus hydralazine, Outcome 1 Persistent high blood pressure.
3.2
3.2. Analysis
Comparison 3 Prostacyclin versus hydralazine, Outcome 2 Caesarean section.
3.3
3.3. Analysis
Comparison 3 Prostacyclin versus hydralazine, Outcome 3 Side‐effects for the woman.
3.4
3.4. Analysis
Comparison 3 Prostacyclin versus hydralazine, Outcome 4 Neonatal death.
3.5
3.5. Analysis
Comparison 3 Prostacyclin versus hydralazine, Outcome 5 Ventilation of the baby.
4.1
4.1. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 1 Maternal death.
4.2
4.2. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 2 Eclampsia.
4.3
4.3. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 3 Persistent high blood pressure.
4.4
4.4. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 4 Hypotension.
4.5
4.5. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 5 Pulmonary oedema.
4.6
4.6. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 6 HELLP syndrome.
4.7
4.7. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 7 Disseminated intravascular coagulation.
4.8
4.8. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 8 Severe maternal morbidity.
4.9
4.9. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 9 Delivery due to fetal distress.
4.10
4.10. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 10 Placental abruption.
4.11
4.11. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 11 Caesarean section.
4.12
4.12. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 12 Side‐effects for the women.
4.13
4.13. Analysis
Comparison 4 Ketanserin versus hydralazine, Outcome 13 Perinatal death.
5.1
5.1. Analysis
Comparison 5 Urapidil versus hydralazine, Outcome 1 Eclampsia.
5.2
5.2. Analysis
Comparison 5 Urapidil versus hydralazine, Outcome 2 Persistent high blood pressure.
5.3
5.3. Analysis
Comparison 5 Urapidil versus hydralazine, Outcome 3 Stillbirth.
5.4
5.4. Analysis
Comparison 5 Urapidil versus hydralazine, Outcome 4 Neonatal death.
5.5
5.5. Analysis
Comparison 5 Urapidil versus hydralazine, Outcome 5 Hypotension.
5.6
5.6. Analysis
Comparison 5 Urapidil versus hydralazine, Outcome 6 Side‐effects for the woman.
5.7
5.7. Analysis
Comparison 5 Urapidil versus hydralazine, Outcome 7 Placental abruption.
5.8
5.8. Analysis
Comparison 5 Urapidil versus hydralazine, Outcome 8 Caesarean section.
5.9
5.9. Analysis
Comparison 5 Urapidil versus hydralazine, Outcome 9 Respiratory distress syndrome.
6.1
6.1. Analysis
Comparison 6 Labetalol versus calcium channel blockers, Outcome 1 Eclampsia.
6.2
6.2. Analysis
Comparison 6 Labetalol versus calcium channel blockers, Outcome 2 Persistent high blood pressure.
6.3
6.3. Analysis
Comparison 6 Labetalol versus calcium channel blockers, Outcome 3 Hypotension.
6.4
6.4. Analysis
Comparison 6 Labetalol versus calcium channel blockers, Outcome 4 Side‐effects for the woman (specific effects).
6.5
6.5. Analysis
Comparison 6 Labetalol versus calcium channel blockers, Outcome 5 Side‐effects for the woman.
6.6
6.6. Analysis
Comparison 6 Labetalol versus calcium channel blockers, Outcome 6 Elective delivery.
6.7
6.7. Analysis
Comparison 6 Labetalol versus calcium channel blockers, Outcome 7 Caesarean section.
6.8
6.8. Analysis
Comparison 6 Labetalol versus calcium channel blockers, Outcome 8 Admission to intensive care.
6.9
6.9. Analysis
Comparison 6 Labetalol versus calcium channel blockers, Outcome 9 Admission to special care baby unit.
7.1
7.1. Analysis
Comparison 7 Labetalol versus methyldopa, Outcome 1 Persistent high blood pressure.
7.2
7.2. Analysis
Comparison 7 Labetalol versus methyldopa, Outcome 2 Changed drugs due to side‐effects.
7.3
7.3. Analysis
Comparison 7 Labetalol versus methyldopa, Outcome 3 Caesarean section.
7.4
7.4. Analysis
Comparison 7 Labetalol versus methyldopa, Outcome 4 Fetal or neonatal death.
7.5
7.5. Analysis
Comparison 7 Labetalol versus methyldopa, Outcome 5 Small‐for‐gestational age.
7.6
7.6. Analysis
Comparison 7 Labetalol versus methyldopa, Outcome 6 Admission to special care baby unit.
8.1
8.1. Analysis
Comparison 8 Labetalol versus diazoxide, Outcome 1 Persistent high blood pressure.
8.2
8.2. Analysis
Comparison 8 Labetalol versus diazoxide, Outcome 2 Low blood pressure, requiring treatment.
8.3
8.3. Analysis
Comparison 8 Labetalol versus diazoxide, Outcome 3 Caesarean section.
8.4
8.4. Analysis
Comparison 8 Labetalol versus diazoxide, Outcome 4 Perinatal deaths.
9.1
9.1. Analysis
Comparison 9 Nitrates versus magnesium sulphate, Outcome 1 Eclampsia.
9.2
9.2. Analysis
Comparison 9 Nitrates versus magnesium sulphate, Outcome 2 Persistent high blood pressure.
9.3
9.3. Analysis
Comparison 9 Nitrates versus magnesium sulphate, Outcome 3 Caesarean section.
10.1
10.1. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 1 Eclampsia.
10.2
10.2. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 2 Stroke.
10.3
10.3. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 3 Persistant high blood pressure.
10.4
10.4. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 4 Hypotension.
10.5
10.5. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 5 Coagulopathy for the woman.
10.6
10.6. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 6 Respiratory difficulty for the woman.
10.7
10.7. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 7 Placental abruption.
10.8
10.8. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 8 Side‐effects for the woman (specific effects).
10.9
10.9. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 9 Side‐effects for the woman (all side‐effects).
10.10
10.10. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 10 Oliguria.
10.11
10.11. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 11 Caesarean section.
10.12
10.12. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 12 Postpartum haemorrhage.
10.13
10.13. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 13 Baby intubated at delivery.
10.14
10.14. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 14 Respiratory distress syndrome.
10.15
10.15. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 15 Low blood pressure for the baby.
10.16
10.16. Analysis
Comparison 10 Nimodipine versus magnesium sulphate, Outcome 16 Hypotonia for the baby.
11.1
11.1. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 1 Maternal death.
11.2
11.2. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 2 Eclampsia.
11.3
11.3. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 3 HELLP syndrome.
11.4
11.4. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 4 Renal failure.
11.5
11.5. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 5 Pulmonary oedema.
11.6
11.6. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 6 Admission to intensive care.
11.7
11.7. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 7 Magnesium sulphate prophylaxis.
11.8
11.8. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 8 Placental abruption.
11.9
11.9. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 9 Caesarean section.
11.10
11.10. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 10 Stillbirth.
11.11
11.11. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 11 Admission to special care baby unit.
11.12
11.12. Analysis
Comparison 11 Nifedipine versus prazosin, Outcome 12 Severe respiratory distress syndrome.
12.1
12.1. Analysis
Comparison 12 Nifedipine versus chlorpromazine, Outcome 1 Eclampsia.
12.2
12.2. Analysis
Comparison 12 Nifedipine versus chlorpromazine, Outcome 2 Persistent high blood pressure.
12.3
12.3. Analysis
Comparison 12 Nifedipine versus chlorpromazine, Outcome 3 Caesarean section.
13.1
13.1. Analysis
Comparison 13 Hydralazine versus diazoxide, Outcome 1 Perinatal death.
13.2
13.2. Analysis
Comparison 13 Hydralazine versus diazoxide, Outcome 2 Stillbirth.
13.3
13.3. Analysis
Comparison 13 Hydralazine versus diazoxide, Outcome 3 Neonatal death.
13.4
13.4. Analysis
Comparison 13 Hydralazine versus diazoxide, Outcome 4 Death in first 7 days.
13.5
13.5. Analysis
Comparison 13 Hydralazine versus diazoxide, Outcome 5 Caesarean section.
13.6
13.6. Analysis
Comparison 13 Hydralazine versus diazoxide, Outcome 6 Respiratory distress syndrome.
13.7
13.7. Analysis
Comparison 13 Hydralazine versus diazoxide, Outcome 7 Necrotising enterocolitis.
13.8
13.8. Analysis
Comparison 13 Hydralazine versus diazoxide, Outcome 8 Apgar score < 7 at 5 minutes.
13.9
13.9. Analysis
Comparison 13 Hydralazine versus diazoxide, Outcome 9 Hypoglycaemia of the baby.
13.10
13.10. Analysis
Comparison 13 Hydralazine versus diazoxide, Outcome 10 Ventilation of the baby.
14.1
14.1. Analysis
Comparison 14 Methyldopa versus atenolol, Outcome 1 Stillbirth.
14.2
14.2. Analysis
Comparison 14 Methyldopa versus atenolol, Outcome 2 Neonatal death.
14.3
14.3. Analysis
Comparison 14 Methyldopa versus atenolol, Outcome 3 Side‐effects for the woman (specific effects).
14.4
14.4. Analysis
Comparison 14 Methyldopa versus atenolol, Outcome 4 Respiratory distress syndrome.
14.5
14.5. Analysis
Comparison 14 Methyldopa versus atenolol, Outcome 5 Apgar score < 7 at 5 minutes.
14.6
14.6. Analysis
Comparison 14 Methyldopa versus atenolol, Outcome 6 Side‐effects for the baby.
15.1
15.1. Analysis
Comparison 15 Urapidil versus calcium channel blockers, Outcome 1 Side‐effects for the woman.
15.2
15.2. Analysis
Comparison 15 Urapidil versus calcium channel blockers, Outcome 2 Side‐effects for the baby.
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References

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Nimodipine SG 2003 {published data only}
    1. Belfort M, Anthony J, Saade G, Nimodipine Study Group. Interim report of the nimodipine vs. magnesium sulfate for seizure prophylaxis in severe preeclampsia study: an international, randomized controlled trial. American Journal of Obstetrics and Gynecology 1998;178(1 Pt 2):S7.
    1. Belfort M, Saade G, Yared M, Abedejos P, Dorman K. Change in estimated cerebral perfusion pressure following nimodipine or magnesium sulfate in patients with severe preeclampsia. American Journal of Obstetrics and Gynecology 1998;178(1 Pt 2):S114. - PubMed
    1. Belfort MA, Anthony J, Saade GR, Allen JC, Nimodipine Study Group. A comparison of magnesium sulfate and nimodipine for the prevention of eclampsia. New England Journal of Medicine 2003;348:304‐11. - PubMed
    1. Belfort MA, Saade GR, Yared M, Grunewald C, Herd JA, Varner MA, et al. Change in estimated cerebral perfusion pressure after treatment with nimodipine or magnesium sulfate in patients with preeclampsia. American Journal of Obstetrics and Gynecology 1999;181:402‐7. - PubMed
    1. Hollenberg NK. A comparison of magnesium sulfate and nimodipine for the prevention of eclampsia. Current Hypertension Reports 2003;5(4):288‐9. - PubMed
N Ireland 1991 {published data only}
    1. Harper A, Murnaghan GA. Maternal and fetal haemodynamics in hypertensive pregnancies during maternal treatment with intravenous hydralazine or labetalol. British Journal of Obstetrics and Gynaecology 1991;98:453‐9. - PubMed
Panama 2006 {published data only}
    1. Vigil‐De Gracia P, Lasso M, Ruiz E, Vega‐Malek JC, Mena FT, Lopez JC, et al. Severe hypertension in pregnancy: hydralazine or labetalol. A randomized clinical trial. European Journal of Obstetrics & Gynecology and Reproductive Biology 2006;128:157‐62. - PubMed
South Africa 1987 {published data only}
    1. Ashe RG, Moodley J, Richards AM, Philpott RH. Comparison of labetalol and dihydralazine in hypertensive emergencies of pregnancy. South African Medical Journal 1987;71:354‐6. - PubMed
South Africa 1989 {published data only}
    1. Moodley J. The use of nifedipine in acute hypertensive emergencies of pregnancy. Proceedings of 6th International Congress, International Society for the Study of Hypertension in Pregnancy; 1988 May 22‐26; Montreal, Canada. 1988:141.
    1. Seabe SJ, Moodley J, Becker P. Nifedipine in acute hypertensive emergencies in pregnancy. South African Medical Journal 1989;76:248‐50. - PubMed
South Africa 1992 {published data only}
    1. Moodley J, Gouws E. A comparative study of the use of epoprostenol and dihydralazine in severe hypertension in pregnancy. British Journal of Obstetrics and Gynaecology 1992;99:727‐30. - PubMed
South Africa 1995 {published data only}
    1. Rossouw HJ, Howarth G, Odendaal HJ. Ketanserin and hydralazine in hypertension in pregnancy ‐ a randomised double‐blind trial. South African Medical Journal 1995;85:525‐8. - PubMed
South Africa 1997 {published data only}
    1. Howarth GR, Seris A, Venter C, Pattinson RC. A randomized controlled pilot study comparing urapidil to dihydralazine in the management of severe hypertension in pregnancy. Hypertension in Pregnancy 1997;16:213‐21.
    1. Pattinson RC, Seris A, Venter CP, Howarth G. Urapidil versus dihydralazine for control of severe hypertension in pregnancy: a pilot study. Proceedings of the 12th Conference on Priorities in Perinatal Care; 1993; South Africa. 1993:140‐3.
South Africa 1997a {published data only}
    1. Maharaj B, Khedun SM, Moodley J, Byl K, Rapiti N. A comparative study of intravenous isradipine and dihydralazine in the treatment of severe hypertension of pregnancy in black patients. Hypertension in Pregnancy 1997;16:1‐9.
    1. Maharaj B, Moodley J, Khedun SM, Rapiti N, Byl K. Intravenous isradipine in the management of severe hypertension in pregnancy. Proceedings of 10th International Congress, International Society for the Study of Hypertension in Pregnancy; 1996 August 4‐8; Seattle, USA. 1996:131.
    1. Maharaj B, Moodley J, Khedun SM, Rapiti N, Byl K. Intravenous isradipine in the management of severe hypertension in pregnancy. Proceedings of 9th International Congress, International Society for the Study of Hypertension in Pregnancy; 1994 March 15‐18; Sydney, Australia. 1994:158.
South Africa 1997b {published data only}
    1. Steyn DW, Odendaal HJ. Dihydralazine or ketanserin for severe hypertension in pregnancy?. Proceedings of 9th International Congress, International Society for the Study of Hypertension in Pregnancy; 1994 March 15‐18; Sydney, Australia. 1994:152.
    1. Steyn DW, Odendaal HJ. Dihydralazine or ketanserin for severe hypertension in pregnancy? Preliminary results. European Journal of Obstetrics & Gynecology and Reproductive Biology 1997;75:155‐9. - PubMed
South Africa 2000 {published data only}
    1. Hall D, Odendaal H, Steyn D, Smith M, Carstens E. Prazosin or nifedipine as a second agent to control early severe hypertension in pregnancy ‐ a randomized controlled trial. 29th Congress of the South African Society of Obstetricians and Gynaecologists; 1998 March 8‐12; South Africa. 1998.
    1. Hall DR, Odendaal HJ, Steyn DW, Smith M. Nifedipine or prazosin as a second agent to control early severe hypertension in pregnancy: a randomised controlled trial. BJOG: an international journal of obstetrics and gynaecology 2000;107:759‐65. - PubMed
    1. Hall DR, Odendaal HJ, Steyn DW, Smith M. Nifedipine or prazosin as a second agent to control early severe hypertension in pregnancy: a randomised controlled trial. Hypertension in Pregnancy 2000;19(Suppl 1):12. - PubMed
    1. Hall DR, Odendaal HJ, Steyn DW, Smith M. Nifedipine or prazosin as a second agent to control early severe hypertension in pregnancy: a randomised controlled trial. Women's Health ‐ into the new millenium. Proceedings of the 4th International Scientific Meeting of the Royal College of Obstetricians and Gynaecologists; 1999 October 3‐6; Cape Town South Africa. RCOG, 1999:49.
Switzerland 2012 {published data only}
    1. Saudan P, Billieux MH, Pechere A, Irion O, Savoldelli G, Boulvain M. Which first‐line drug to control severe hypertension in pregnancy? A pilot study. Pregnancy Hypertension 2012;2(3):182. - PubMed
Tunisia 2002 {published data only}
    1. Elatrous S, Nouira S, Ouanes Besbes L, Marghli S, Boussarssar M, Sakkouhi M, et al. Short‐term treatment of severe hypertension of pregnancy: prospective comparison of nicardipine and labetalol. Intensive Care Medicine 2002;28(9):1281‐6. - PubMed
Turkey 1996 {published data only}
    1. Belfort M, Taskin O, Buhur A, Saade G, Yalcinoglu A. Intravenous nimodipine in the management of severe preeclampsia: a double blind randomised controlled clinical trial. Proceedings of 10th International Congress, International Society for the Study of Hypertension in Pregnancy; 1996 August 4‐8; Seattle, USA. 1996:124.
USA 1987 {published data only}
    1. Mabie WC, Gonzalez AR, Amon E, Sibai BM. A comparative trial of labetalol and hydralazine in the acute management of severe hypertension complicating pregnancy. Proceedings of 6th Annual Meeting of the Society of Perinatal Obstetricians; 1986; San Antonio, USA. 1986:221. - PubMed
    1. Mabie WC, Gonzalez AR, Sibai BM, Amon E. A comparative trial of labetalol and hydralazine in the acute management of severe hypertension complicating pregnancy. Obstetrics & Gynecology 1987;70:328‐33. - PubMed
    1. Mabie WC, Gonzalez‐Ruiz A, Amon E, Sibai BM. A comparative trial of labetolol and hydralazine for acute management of severe hypertension complicating pregnancy. Proceedings of 5th International Congress, International Society for the Study of Hypertension in Pregnancy; 1986 July 7‐10; Nottingham, UK. 1987:91.

References to studies excluded from this review

Adair 2009 {published data only}
    1. Adair CD, Luper A, Rose JC, Russell G, Veille JC, Buckalew VM. The hemodynamic effects of intravenous digoxin‐binding fab immunoglobulin in severe preeclampsia: a double‐blind, randomized, clinical trial. Journal of Perinatology 2009;29(4):284‐9. - PubMed
Adair 2010 {published data only}
    1. Adair CD, Buckalew V, Graves SW, Chauhan N, Lam G, DEEP studygroup. Digoxin Immune Fab treatment for severe preeclampsia; relationship between response and baseline endogenous digitalis‐like factor. Pregnancy Hypertension 2010;1 Suppl 1:S21.
    1. Adair CD, Buckalew VM, Graves SW, Lam GK, Johnson DD, Saade G, et al. Digoxin immune fab treatment for severe preeclampsia. American Journal of Perinatology 2010;27(8):655‐62. - PubMed
Anonymous 2006 {published data only}
    1. Anonymous. Sildenafil citrate for the treatment of established pre‐eclampsia (ongoing trial). ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 21 March 2006).
Argentina 1986 {published data only}
    1. Voto L, Lapidus A, Neira J, Margulies M. Atenolol versus alpha methyl dopa in the treatment of hypertension in pregnancy. Proceedings of the 5th International Congress, International Society for the Study of Hypertension in Pregnancy; 1986 July 7‐10; Nottingham, UK, 1986. 1986:138.
Aslam 2007 {published data only}
    1. Aslam A, Talat W. Pregnancy induced hypertension; anti‐hypertensive therapy in a study using single drug versus multiple drugs. Professional Medical Journal 2007;14(1):30‐2.
Australia 2002 {published data only}
    1. Brown MA, Buddle ML, Farrell T, Davis GK. Efficacy and safety of nifedipine tablets for the acute treatment of severe hypertension in pregnancy. American Journal of Obstetrics and Gynecology 2002;187:1046‐50. - PubMed
    1. Buddle ML, Brown MA, Farrell T. Rapid treatment of severe hypertension in pregnancy. 37th Annual Scientific Meeting of the Australian and New Zealand Society of Nephrology; 2001 September 5‐7; Darwin, Australia. 2001:118.
Bangladesh 2002 {published data only}
    1. Begum MR, Quadir E, Begum A, Akhter S, Rahman K. Management of hypertensive emergencies of pregnancy by hydralazine bolus injection vs continuous drip‐‐a comparative study. Medscape Womens Health eJournal 2002;7(5):1‐6. - PubMed
Belfort 2006 {published data only}
    1. Belfort MA. Labetalol versus MgSO4 for the prevention of eclampsia trial (ongoing trial). ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 21 March 2006).
Brazil 1984 {published data only}
    1. Kahhale S, Carrara W, Barros ACSD, Zugaib M, Neme B. A comparative study between treated (beta‐blocker pindolol) and untreated chronic hypertension. 4th World Congress of the International Society for the study of Hypertension in Pregnancy; 1984 June 18‐21; Amsterdam, The Netherlands. 1984:56.
    1. Kahhale S, Zugaib M, Carrara W, Jota de Paula F, Sabbaga E, Neme B. Comparative study of chronic hypertensive pregnant women treated and non‐treated with pindolol. Ginecologia e Obstetricia Brasileiras 1985;8(2):85‐9.
Brazil 1988 {published data only}
    1. Bruno RM, Germany L, Behle I, Barros E. Nifedipine versus hydralazine: randomized, placebo‐controlled and double blind trial in severe hypertension complicating pregnancy [Nifedipina versus hidralazina: estudo randomizado e duplo cego no tratemento agudo da hipertensao arterial severa na gravidez]. Revista do Hospital de Clinicas de Porto Alegre 1988;8:75‐8.
Brazil 1988a {published data only}
    1. Atallah A, Delascio D, Santos J, Mesquita G, Kenj G. Double blinded randomized controlled study using hydralazine or nifedipine for hypertensives crisis in pregnancy. World Congress of Gynecology and Obstetrics; 1988 October 23‐28; Brazil. 1988:181.
    1. Atallah AN, Souza Mesquita MR, dos Santos JFK, Bertini AM, Gebara M, Camano L, et al. A randomized controlled study of hydralazine and nifedipine in hypertensive crisis during pregnancy. Revista Brasileira de Ginecologia y Obstetricia 1990;12:10‐4.
China 2000 {published data only}
    1. Yang X, Liu Y. The effect of nifedipine on postpartum blood loss in patients with pregnancy induced hypertension [Chinese]. Chung‐Hua Fu Chan Ko Tsa Chih [Chinese Journal of Obstetrics & Gynecology] 2000;35(3):151‐2. - PubMed
Devi 2012 {published data only}
    1. Devi R, Anjali T. Intravenous labetalol versus oral nifedipine in the treatment of severe hypertension in pregnancy. Kuwait Medical Journal 2012;44(4):287‐90.
Egerman 2008 {published data only}
    1. Egerman R. Evaluation of the safety of relaxin in severe preeclampsia. ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 20 February 2008).
Egypt 1988 {published data only}
    1. Salem H, Ghanemah S, Seleem S, Sayed E, Abdel‐Latif A, Chard T. Bromocriptine therapy in pre‐eclamptic toxaemia of pregnancy (PET). World Congress of Gynecology and Obstetrics; 1988 October 23‐28; Brazil, 1988. 1988:184.
Egypt 1989 {published data only}
    1. Toppozada M, Barakat T, Shaala S, Ismail AAA. Management of severe pre‐eclampsia with prostaglandin A1: a useful therapeutic approach. Journal of Obstetrics and Gynaecology 1989;9:184‐8.
Egypt 1992 {published data only}
    1. Toppozada M, Medhat I, Sallam H, Ismail AAA, El‐Badawy ES, Rabbo SA. Improving placental blood flow in pre‐eclampsia with prostaglandin A1. Acta Obstetricia et Gynecologica Scandinavica 1992;71:22‐7. - PubMed
Esmaoglu 2009 {published data only}
    1. Esmaoglu A, Ulgey A, Akin A, Boyaci A. Comparison between dexmedetomidine and midazolam for sedation of eclampsia patients in the intensive care unit. Journal of Critical Care 2009;24(4):551‐5. - PubMed
France 1986 {published data only}
    1. Fievet P, Esper N, Gueroult J, Gueroult J, Fournier A. Comparative study of clonidine and labetalol in severe hypertension induced by pregnancy. 5th International Congress for the International Society for the study of Hypertension in Pregnancy; 1986 July 7‐10; Nottingham, England. 1986:136.
Ghana 1995 {published data only}
    1. Kwawukume EY, Ghosh TS. Oral nifedipine therapy in the management of severe preeclampsia. International Journal of Gynecology & Obstetrics 1995;49:265‐9. - PubMed
Graves 2012 {published data only}
    1. Graves SW, Hopoate‐Sitake M, Johnston A, Buckalew V, Lam G, Mason L, et al. Deep trial secondary analysis: Digoxin immune fab fragment treatment has additional benefits in endogenous digitalis‐like factor positive preeclamptic women. Pregnancy Hypertension 2012;2(3):287‐8. - PubMed
Gris 2011 {published data only}
    1. Gris JC, Chauleur C, Molinari N, Mares P, Fabbro‐Peray P, Quere I, et al. Addition of enoxaparin to aspirin for the secondary prevention of placental vascular complications in women with severe pre‐eclampsia: The pilot randomised controlled NOH‐PE trial. Thrombosis and Haemostasis 2011;106(6):1053‐61. - PubMed
Hladunewich 2006 {published data only}
    1. Hladunewich MA, Derby GC, Lafayette RA, Blouch KL, Druzin ML, Myers BD. Effect of L‐Arginine therapy on the glomerular injury of preeclampsia: a randomized controlled trial. Obstetrics & Gynecology 2006;107(4):886‐95. - PubMed
Hopate 2008 {published data only}
    1. Hopate M, Graves S, Adair CD, Lam G, Johnson D, Saade G, et al. In‐vivo reversal of functional sodium pump inhibition with Digibind treatment. Hypertension in Pregnancy 2008;27(4):460.
India 1963 {published data only}
    1. Daftary SN, Desa Souza JM, Kumar A, Mandrekar SS, Lotlikar KD, Sheth UK. A controlled clinical trial of guanethidine in toxemia of pregnancy. Indian Journal of Medical Sciences 1963;17:812‐8. - PubMed
India 2001 {published data only}
    1. Samal S, Gupta U, Agarwal P. Management of eclampsia with magnesium sulphate and nifedipine. Journal of Obstetrics and Gynecology of India 2001;51(3):71‐4.
Iran 1994 {published data only}
    1. Ghahiri A, Salehpour S. The effect of nifedipin on the BP of the patients with severe preeclampsia. International Journal of Gynecology & Obstetrics 1994;46:121.
Israel 1991 {published data only}
    1. Fenakel K, Fenakel G, Appelman Z, Lurie S, Katz Z, Shoham Z. Nifedipine in the treatment of severe preeclampsia. Obstetrics & Gynecology 1991;77:331‐7. - PubMed
Israel 1999 {published data only}
    1. Thaler I, Amit A, Kamil D, Itskovitz‐Eldor J. The effect of isosorbide dinitate on placental blood flow and maternal blood pressure in women with pregnancy induced hypertension. American Journal of Hypertension 1999;12:341‐7. - PubMed
Italy 2004 {published data only}
    1. Paternoster DM, Fantinato S, Manganelli F, Milani M, Nicolini U, Girolami A. Efficacy of AT in pre‐eclampsia: a case control prospective trial. Thrombosis and Haemostasis 2004;91(2):283‐9. - PubMed
Jamaica 1999 {published data only}
    1. Fletcher H, Roberts G, Mullings A, Forrester T. An open trial comparing isradipine with hydralazine and methyl dopa in the treatment of patients with severe pre‐eclampsia. Journal of Obstetrics and Gynaecology 1999;19:235‐8. - PubMed
    1. Fletcher H, Roberts G, Mullings A, Simeon DT, Forrester TE. An open trial comparing usual care (hydralazine) with injectable isradipine in severe pre‐eclampsia [abstract]. West Indian Medical Journal 1996;45(2 Suppl):27.
Japan 1999 {published data only}
    1. Kanayama N, Belayet HM, Khatun S, Tokunaga N, Sugimura M, Kobayashi T, et al. A new treatment of severe pre‐eclampsia by long term epidural anaesthesia. Journal of Human Hypertension 1999;13:167‐71. - PubMed
Japan 2000 {published data only}
    1. Maki M, Kobayashi T, Terao T, Ikenoue T, Satoh K, Nakabayashi M, et al. Antithrombin therapy for severe preeclampsia: results of a double‐blind, randomized, placebo‐controlled trial. Bi51.017 Study group. Thrombosis and Haemostasis 2000;84(4):583‐90. - PubMed
Japan 2002 {published data only}
    1. Seki H, Takeda S, Kinoshita K. Long‐term treatment with nicardipine for severe pre‐eclampsia. International Journal of Gynecology & Obstetrics 2002;76:135‐41. - PubMed
Japan 2003 {published data only}
    1. Kobayashi T, Terao T, Ikenoue T, Sameshima H, Nakabayashi M, Kajiwara Y, et al. Treatment of severe preeclampsia with antithrombin concentrate: results of a prospective feasibility study. Seminars in Thrombosis and Hemostasis 2003;29(6):645‐52. - PubMed
Johnston 2006 {published data only}
    1. Johnston A. Efficacy study of digibind for treatment of severe preeclampsia (ongoing trial). ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 21 March 2006).
Lam 2008 {published data only}
    1. Lam G, Johnson D, Robinson C, Saade G, Lewis D, Porter K, et al. Antepartum administration of a digoxin immune fab (Digibind) improves renal function in patients with severe preeclampsia. Hypertension in Pregnancy 2008;27(4):422.
Malaysia 1996 {published data only}
    1. Jegasothy R, Paranthaman S. Sublingual nifedipine compared with intravenous hydrallazine in the acute treatment of severe hypertension in pregnancy: potential for use in rural practice. Journal of Obstetrics and Gynaecology Research 1996;22:21‐4. - PubMed
Manzur‐Verastegui 2008 {published data only}
    1. Manzur‐Verastegui S, Mandeville PB, Gordillo‐Moscoso A, Hernandez‐Sierra JF, Rodriguez‐Martinez M. Efficacy of nitroglycerine infusion versus sublingual nifedipine in severe pre‐eclampsia: a randomized, triple‐blind, controlled trial. Clinical and Experimental Pharmacology and Physiology 2008;35(5‐6):580‐5. - PubMed
Mexico 1967 {published data only}
    1. Sandoval JB, Perez FR. Study of glomerular filtration in toxemia of pregnancy. Modifications with the use of furosemid (lasix) [abstract]. 5th World Congress of Gynecology and Obstetrics; 1967; Sydney, Australia. 1967:891.
Mexico 2000 {published data only}
    1. Martinez‐Abundis E, Gonzalez‐Ortiz M, Hernandez‐Salazar F, Huerta‐J‐Lucas MT. Sublingual isosorbide dinitrate in the acute control of hypertension in patients with severe preeclampsia. Gynecologic and Obstetric Investigation 2000;50:39‐42. - PubMed
Mexico 2004 {published data only}
    1. Pardo‐Morales RV, Romero‐Figueroa S, Vazquez‐de Anda GF, Briones‐Garduno JC, Herrera‐Villalobos JE, Gonzalez‐Vargas A. New therapeutics alternative in severe preeclampsia. Cirugia y Cirujanos 2004;72(3):203‐7. - PubMed
Netherlands 2002 {published data only}
    1. Roes EM, Raijmakers MTM, Zusterzeel PLM, Boo T, Merkus JMWM, Peters WHM, et al. Oral n‐acetylcysteine supplementation does not prolong pregnancy in women with severe preeclampsia: a randomised, placebo‐controlled trial [abstract]. Hypertension in Pregnancy 2002;21(Suppl 1):47.
New Zealand 1986 {published data only}
    1. Lubbe W. Maternal and fetal responses to b‐blockers with and without ISA in hypertensive pregnancy. 5th International Congress for the International Society for the study of Hypertension in Pregnancy; 1986 July 7‐10; Nottingham, England. 1986:89.
New Zealand 1992 {published and unpublished data}
    1. Duggan PM, McCowan LME, Stewart AW. Antihypertensive drug effects on placental flow velocity waveforms in pregnant women with severe hypertension. Australian and New Zealand Journal of Obstetrics and Gynaecology 1992;32:335‐8. - PubMed
Philipines 2000 {published data only}
    1. Decano MB, Cabrera LT. The effects of transdermal nitroglycerin (nitrol patch) on the uterine and umbilical artery blood flow in preeclampsia: a randomized double blind placebo controlled study [abstract]. XVI FIGO World Congress of Obstetrics & Gynecology; 2000 Sept 3‐8; Washington DC, USA (Book 1). 2000:26.
Pogue 2006 {published data only}
    1. Pogue V, Ticas R, Sandoval X. Removal of agonistic autoantibodies against the angiotensin AT receptor in patients with preeclampsia [abstract]. Journal of the American Society of Nephrology 2006;17:658A.
Roes 2006 {published data only}
    1. Roes EM, Raijmakers MT, Boo TM, Zusterzeel PL, Merkus HM, Peters WH, et al. Oral n‐acetylcysteine administration does not stabilise the process of established severe preeclampsia. European Journal of Obstetrics & Gynecology and Reproductive Biology 2006;127(1):61‐7. - PubMed
Samangaya 2009 {published data only}
    1. Samangaya RA, Mires G, Shennan A, Skillern L, Howe D, McLeod A, et al. A randomised, double‐blinded, placebo‐controlled trial of the phosphodiesterase type 5 inhibitor sildenafil in the treatment of preeclampsia. Hypertension in Pregnancy 2009;28:369‐82. - PubMed
    1. Samangaya RA, Wareing M, Skillern L, Baker PN. Phosphodiesterase inhibitor effect on small artery function in preeclampsia. Hypertension in Pregnancy 2011;30(2):144‐52. - PubMed
Schackis 2004 {published data only}
    1. Schackis RC. Hyperuricaemia and preeclampsia: is there a pathogenic link?. Medical Hypotheses 2004;63(2):239‐44. - PubMed
Scotland 1983 {published data only}
    1. Walker JJ, Greer I, Calder AA. Treatment of acute pregnancy‐related hypertension: labetalol and hydralazine compared. Postgraduate Medical Journal 1983;59:168‐70. - PubMed
Singapore 1971 {published data only}
    1. Ratnam SS, Lean TH, Sivasamboo R. A comparison of hypotensive drugs in patients with hypertensive disorders in late pregnancy. Australian and New Zealand Journal of Obstetrics and Gynaecology 1971;11:78‐84. - PubMed
Smith 2005 {published data only}
    1. Smith D, Warren J, Saade G, Clark S, Belfort M. Oral labetalol given to treated non hypertensive patients with preeclampsia is no more likely to cause hypotension than magnesium sulfate [abstract]. American Journal of Obstetrics and Gynecology 2005;193(6 Suppl):S78.
South Africa 1982 {published data only}
    1. Garden A, Davey DA, Dommisse J. Intravenous labetalol and intravenous dihydralazine in severe hypertension in pregnancy. Clinical and Experimental Hypertension 1982;B1:371‐83. - PubMed
South Africa 1984 {published data only}
    1. Sankar D, Moodley J. Low‐dose diazoxide in the emergency management of severe hypertension in pregnancy. South African Medical Journal 1984;65:279‐80. - PubMed
South Africa 1993 {published and unpublished data}
    1. Bhorat IE, Datshana P, Naidoo P, Rout CC, Moodley J. Malignant ventricular arrhythmias in eclampsia: a comparison of labetalol with dihydralazine. American Journal of Obstetrics and Gynecology 1993;168:1292‐6. - PubMed
    1. Bhorat IE, Naidoo DP, Rout CC, Moodley J. Malignant ventricular arrhythmias in eclampsia: a comparison of labetalol with dihydralazine. Proceedings of 9th International Congress, International Society for the Study of Hypertension in Pregnancy; 1994 march 15‐18; Sydney, Australia. 1994:162.
South Africa 2002 {published data only}
    1. Schie D, Jeu R, Steyn D, Odendaal H, van GH. The optimal dosage of ketanserin for pateints with severe hypertension in pregnancy. European Journal Obstetrics & Gynecology and Reproductive Biology 2002;102:161‐6. - PubMed
Spain 1988 {published data only}
    1. Cararach V, Torres Pons PJ, Roca M, Codina C, Cobo E, Gonzalez‐Merlo J. Treatment of severe hypertension in pregnancy. Double blind controlled trial a treatment pattern (TP) with hydralazine + methyldopa a single TP with labetolol. Proceedings of 6th International Congress, International Society for the Study of Hypertension in Pregnancy; 1988 May 22‐26; Montreal, Canada. 1988:101.
Steyn 2003 {published data only}
    1. Steyn DW, Hall DR, Odendaal H. The optimal dosage of nifedipine in patients with early onset severe pre‐eclampsia ‐ a randomised controlled trial. 22nd Conference on Priorities in Perinatal Care in South Africa; 2003 March 11‐14; Free State, South Africa. 2003.
Sweden 1993 {published and unpublished data}
    1. Hjertberg R, Faxelius G, Belfrage P. Comparison of outcome of labetalol or hydralazine therapy during hypertension in pregnancy in very low birth weight infants. Acta Obstetricia et Gynecologica Scandinavica 1993;72:611‐5. - PubMed
    1. Hjertberg R, Faxelius G, Lagercrantz H. Neonatal adaptation in hypertensive pregnancy ‐ a study of labetalol vs hydralazine treatment. Journal of Perinatal Medicine 1993;21:69‐75. - PubMed
    1. Hjertberg R, Faxelius G, Lagercrantz H. Neonatal adaptation in hypertensive pregnancy ‐ a study of labetalol vs hydralazine treatment. Proceedings of 14th European Congress of Perinatal Medicine; 1994 June 5‐8; Helsinki, Finland. 1994:18. - PubMed
Unemori 2009 {published data only}
    1. Unemori E, Sibai B, Teichmana SL. Scientific rationale and design of a phase I safety study of relaxin in women with severe preeclampsia. Annals of the New York Academy of Sciences 2009;1160:381‐4. - PubMed
USA 1999 {published data only}
    1. Scardo JA, Vermillion ST, Newman RB, Chauhan SP, Brost B. Randomized double blinded hemodynamic study of oral nifedipine and IV labetolol in hypertensive urgencies of pregnancy. American Journal of Obstetrics and Gynecology 1999;180(1 Pt 2):S18. - PubMed
    1. Scardo JA, Vermillion ST, Newman RB, Chauhan SP, Hogg BB. A randomized double blind hemodynamic evaluation of nifedipine and labetolol in preeclamptic hypertensive emergencies. American Journal of Obstetrics and Gynecology 1999;181:862‐6. - PubMed
    1. Vermillion S, Scardo J, Newman R, Chauhan S. A prospective randomized double blind trial of oral nifedipine and intravenous labetolol in hypertensive emergencies. American Journal of Obstetrics and Gynecology 1999;180(1 Pt 2):S14. - PubMed
    1. Vermillion ST, Scardo JA, Newman RB, Chauhan SP. A randomized double blind trial of oral nifedipine and intravenous labetolol in hypertensive emergencies of pregnancy. American Journal of Obstetrics and Gynecology 1999;181:858‐61. - PubMed
Venezuela 2001 {published data only}
    1. Reyna‐Villasmil E, Prieto‐Franchi M, Guerra‐Velazquez M, Torres‐Montilla M. Effect of transdermal nitroglycerin on umbilical artery blood flow in preeclampsia [abstract]. Journal of Perinatal Medicine 2001;29 Suppl 1(Pt 2):486.
Waheed 2005 {published data only}
    1. Waheed F, Chohan A. Comparison of intravenous hydralazine‐bolus dose versus continuous infusion drip in eclampsia. Annals of King Edward Medical College 2005;11(4):521‐3.
Warren 2004 {published data only}
    1. Chandran JR, Devi U, Devi S, Khadeeja M, Vinayachandran S, Jacob KJ, et al. LAMPET Trial (labetalol vs magnesium sulfate in prevention of eclampsia trial). 54th All India Congress of Obstetrics and Gynaecology; 2011 January 5‐9; Hyderabad, Andhra Pradesh, India. 2011:55.
    1. Warren J, Lacoursiere Y, Varner M, Silver R, Anthony J, Belfort M. First interim report on the labetalol versus magnesium sulfate for the prevention of eclampsia trial (LAMPET) [abstract]. Hypertension in Pregnancy 2004;23(Suppl 1):9.

References to studies awaiting assessment

Mesquita 1995 {published data only}
    1. Mesquita MRDS, Atallah AN, Rocha NDSC, Camano L, Bertini AM. The use of hydralazine and nifedipine in hypertensive emergencies in pregnancy [Emprego da hidralazina e da nifedipina nas emergencias hipertensivas na gestacao]. Revista Brasileira de Ginecologia e Obstetricia 1995;17(2):103‐11.

References to ongoing studies

Diemunsch 2008 {published data only}
    1. Diemunsch PA. Treatment of severe hypertension during pre‐eclampsia. A preliminary equivalence study between urapidil and nicardipine. ClinicalTrials.gov (http://clinicaltrials.gov/) (accessed 20 February 2008).

Additional references

Abalos 2007
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CEMD‐UK 2011
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Churchill 2002
    1. Churchill D, Duley L. Interventionist versus expectant care for severe pre‐eclampsia before term. Cochrane Database of Systematic Reviews 2002, Issue 3. [DOI: 10.1002/14651858.CD003106] - DOI - PubMed
Clarke 2002
    1. Clarke M, Oxman AD, editors. Cochrane Reviewers’ Handbook 4.1.5 [updated April 2002]. In: The Cochrane Library, Issue 3, 2002. Oxford: Update Software. Updated quarterly.
de Swiet 2002
    1. Redman CWG. Hypertension. In: Swiet M editor(s). Medical Disorders in Obstetric Practice. 4th Edition. Blackwell Scientific Publications, 2002:159.
Duley 1999
    1. Duley L, Williams J, Henderson‐Smart DJ. Plasma volume expansion for treatment of pre‐eclampsia. Cochrane Database of Systematic Reviews 1999, Issue 4. [DOI: 10.1002/14651858.CD001805] - DOI - PMC - PubMed
Duley 2009
    1. Duley L, Henderson‐Smart DJ, Walker GJA. Interventions for treating pre‐eclampsia and its consequences: generic protocol. Cochrane Database of Systematic Reviews 2009, Issue 2. [DOI: 10.1002/14651858.CD007756] - DOI
Duley 2010
    1. Duley L, Gülmezoglu AM, Henderson‐Smart DJ, Chou D. Magnesium sulphate and other anticonvulsants for women with pre‐eclampsia. Cochrane Database of Systematic Reviews 2010, Issue 11. [DOI: 10.1002/14651858.CD000025.pub2] - DOI - PMC - PubMed
Duley 2010a
    1. Duley L, Gülmezoglu AM, Chou D. Magnesium sulphate versus lytic cocktail for eclampsia. Cochrane Database of Systematic Reviews 2010, Issue 9. [DOI: 10.1002/14651858.CD002960.pub2] - DOI - PMC - PubMed
Hennessy 2007
    1. Hennessy A, Thornton CE, Makris A, Ogle RF, Henderson‐Smart DJ, Gillin AG, et al. A randomised comparison of hydralazine and mini‐bolus diazoxide for hypertensive emergencies in pregnancy: the PIVOT trial. Australian and New Zealand Journal of Obstetrics and Gynaecology 2007;47(4):279‐85. [PUBMED: 17627681] - PubMed
Higgins 2011
    1. Higgins JPT, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from www.cochrane‐handbook.org.
Lindheimer 2008
    1. Lindheimer MD, Taler SJ, Cunningham FG. Hypertension in pregnancy. Journal of the American Society of Hypertension 2008;2(6):484‐94. - PubMed
Lowe 2009
    1. Lowe SA, Brown MA, Dekker GA, Gatt S, McLintock CK, McMahon LP. Guidelines for the management of hypertensive disorders of pregnancy. Australia and New Zealand Journal of Obstetrics and Gynaecology 2009;49(3):242‐6. - PubMed
Magee 2003
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Magee 2008
    1. Magee L, Helewa, ME, Moutquin, JM, von Dadelszen, P. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Journal of Obstetrics and Gynaecology Canada 2008;30(Supp 1):S1‐S48. - PubMed
NICE 2010
    1. National Institute of Clinical Excellence. NICE clinical guideline No. 107. Hypertension in Prenancy. Management of Hypertensive Disorders in Pregnancy. http://www.nice.org.uk/nicemedia/live/13098/50418/50418.pdf 2010.
RevMan 2000 [Computer program]
    1. The Cochrane Collaboration. Review Manager (RevMan). Version 4.1 for Windows. Oxford, England: The Cochrane Collaboration, 2000.
RevMan 2011 [Computer program]
    1. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.
Roberts 2009
    1. Roberts JM, Hubel CA. The two stage model of preeclampsia: variations on the theme. Placenta 2009;30(Suppl 1):32‐7. - PMC - PubMed
Tomassoni 2008
    1. Tomassoni D, Lanari A, Silvestrelli G, Traini E, Amenta F. Nimodipine and its use in cerebrovascular disease: evidence from recent preclinical and controlled clinical studies. Clinical and Experimental Hypertension 2008;30(8):744‐66. - PubMed
Tuffnell 2006
    1. Tuffnell D, Shennan AH, Waugh JJS, Walker JJ. The management of severe pre‐eclampsia/eclampsia. RCOG guideline number 10(A). Royal College of Obstetricians and Gynaecologists, 2006.
WHO 1988
    1. World Health Organization International Collaborative Study of Hypertensive Disorders of Pregnancy. Geographic variation in the incidence of hypertension in pregnancy. American Journal of Obstetrics and Gynecology 1988;158:80‐3. - PubMed
WHO 2011
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Woudstra 2010
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References to other published versions of this review

Duley 1995a
    1. Duley L. IV labetalol vs iv diazoxide in severe pre‐eclampsia. In: Keirse MJNC, Renfrew MJ, Neilson JP, Crowther C (eds.) Pregnancy and Childbirth Module. In: The Cochrane Pregnancy and Childbirth Database Issue 2, Oxford: Update Software 1995.
Duley 1995b
    1. Duley L. Labetalol vs hydralazine in severe pregnancy‐induced hypertension. In: Keirse MJNC, Renfrew MJ, Neilson JP, Crowther C (eds.) Pregnancy and Childbirth Module. In: The Cochrane Pregnancy and Childbirth Database Issue 2, Oxford: Update Software 1995.
Duley 1995c
    1. Duley L. Nifedipine vs hydralazine in severe pregnancy‐induced hypertension. In: Keirse MJNC, Renfrew MJ, Neilson JP, Crowther C (eds.) Pregnancy and Childbirth Module. In: The Cochrane Pregnancy and Childbirth Database Issue 2, Oxford: Update Software 1995.
Duley 1995d
    1. Duley L. Prostacyclin vs dihydralazine in severe hypertension. In: Keirse MJNC, Renfrew MJ, Neilson JP, Crowther C (eds.) Pregnancy and Childbirth Module. In: The Cochrane Pregnancy and Childbirth Database Issue 2, Oxford: Update Software 1995.
Duley 1999a
    1. Duley L, Henderson‐Smart DJ. Drugs for rapid treatment of very high blood pressure during pregnancy. Cochrane Database of Systematic Reviews 1999, Issue 2. [DOI: 10.1002/14651858.CD001449] - DOI - PubMed
Duley 2002c
    1. Duley L, Henderson‐Smart DJ. Drugs for rapid treatment of very high blood pressure during pregnancy. Cochrane Database of Systematic Reviews 2002, Issue 3. [DOI: 10.1002/14651858.CD001449] - DOI - PubMed
Duley 2006
    1. Duley L, Henderson‐Smart DJ, Meher S. Drugs for treatment of very high blood pressure during pregnancy. Cochrane Database of Systematic Reviews 2006, Issue 3. [DOI: 10.1002/14651858.CD001449.pub2] - DOI - PubMed

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