Three of the six trials looked at prevention of postpartum hypertension in a total of 315 women. All compared drug vs. placebo or no treatment; two involved oral furosemide 20-40 mg/day, and the other involved nifedipine capsules 10 mg every 4 hours. There were no cases of hypotension, serious maternal morbidity, or maternal death. Only one study—which included just 18 patients—examined maternal length of stay, finding an insignificant difference of 7.3 vs. 7.6 days.
The other three trials were treatment studies that included just 144 women. None compared antihypertensive medication with placebo or no treatment for mild to moderate hypertension. Two of the studies—involving 106 women—compared oral timolol or hydralazine with methyldopa for mild to moderate hypertension, and the third compared hydralazine plus nifedipine with nifedipine alone for severe postpartum hypertension.
There were no maternal deaths in the three treatment studies, and the need for additional antihypertensive therapy did not differ between groups.
Based on these minimal data, Dr. Sadeghi and her associates concluded: “If a clinician feels that antihypertensive therapy is needed, the agent used should be based on his/her familiarity with the drug.”