Furosemide accelerates postpartum BP recovery in women with
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Persistent postpartum hypertension is a significant cause of maternal morbidity. The objective of this was to study the effect of furosemide on postpartum blood pressure recovery in women with hypertensive disorders of pregnancy. Researchers performed a randomized, double-blind, placebo-controlled trial of a 5-day course of 20 mg oral furosemide versus placebo in women with gestational hypertension and preeclampsia with/without severe features from June 2018 to October 2019.

Primary outcomes were persistent hypertension at 7 days postpartum (using generalized linear models to calculate adjusted relative risk) and days to resolution of hypertension (Kaplan-Meier curves), stratified by severe/nonsevere hypertensive disease. Secondary outcomes included readmissions and need for additional hypertensive medication.We randomized 384 women (192 per group). Baseline characteristics were similar except cesarean delivery rate was higher in the furosemide group (29% versus 20%).

In women randomized to furosemide, there was a 60% reduction in the prevalence of persistently elevated blood pressure at 7 days when controlling for cesarean. The magnitude of reduction was greater in women with nonsevere disease.

Number of days to blood pressure resolution was significantly shorter among women with nonsevere disease randomized to furosemide (8.5 versus 10.5).

There were no significant differences in readmissions or need for additional antihypertensive medication postpartum between groups. In this double-blinded randomized trial, a short course of postpartum furosemide significantly improved blood pressure control in women with hypertensive disorders of pregnancy, mostly among women without severe disease.

Source: https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.120.16133?af=R
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