An open trial comparing usual care (hydralazine) with injectable Isradipine in severe pre-eclampsia

ABSTRACT

Pre-eclampsia is characterised by generalized vasospasm. When this affects the placental bed it causes foetal compromise. These placental bed vessels are under the control of locally acting agents such as electrolytes and are not influenced by neural acting vasodilators such as hydralazine. Calcium channel blockers such as isradipine should work on these vessels and therefore improve the outcome of these pregnancies compared with hydralazine. We did a randomized comparative trial with these two agents used parenterally, in 27 patients with severe pre-eclampsia. The main outcome variables examined were age, parity, bloodpressure before and after treatment, length of prolongation of the pregnancy after start of treatment, complications and foetal outcome. There were no significant differences between the two groups in pre-treatment or post-treatment variables. In conclusion we believe that isradipine offers no advantage over hydralazine in severe pre-eclampsia (AU)