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

Abstract

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.