Fetal Distress After Hydralazine Therapy for Severe Pregnancy-Induced Hypertension

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Abstract
Hydralazine is the most commonly used antihypertensive agent for patients with severe toxemic states. Its use, however, can produce hypotension and acute uteroplacental insufficiency, resulting in fetal distress. Our review of hospital charts of severely preeclamptic or eclamptic patients observed during a two-year period showed that 24 of 77 patients were treated with hydralazine; the remainder were not. Of those receiving hydralazine, 38% (9/24) were delivered by cesarean section because of fetal distress, as compared to 9% (5/53) of those not receiving hydralazine (P less than .01). Of patients whose hydralazine therapy was inappropriate, 82% (9/11) incurred fetal distress versus 38% (5/13) when hydralazine was appropriately administered (P less than .05). In patients receiving hydralazine, fetal distress is in part the consequence of the severity of the disease, but excess use of antihypertensive agents appears to increase this risk.

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