Utilization of hydralazine or alpha-methyldopa for the management of early puerperal hypertension

Abstract

Despite the importance of pregnancy-induced hypertension (PIH), there are few published investigations of therapeutic approaches for the postpartum management of such patients. Twenty-six gravida patients with PIH were prospectively studied during the first 24 hours after delivery while receiving intravenous magnesium sulfate. Each study subject was randomly assigned to a group also systemically administered either hydralazine or methyldopa. During the study interval, hourly measurements of blood pressure, pulse, fluid intake, and urine output were recorded. Hydralazine was found to be superior in its ability to effect more rapidly a lower mean arterial blood pressure. No significant differences in urine output or time until onset of diuresis were noted among treatment groups. No serious side effects were encountered with the use of either antihypertensive agent. Based on these preliminary findings, it appears that hydralazine is the less costly and more effective medication to lower mean arterial blood pressure in the immediate postpartum period.