Furosemide beneficial to women with hypertensive disorders of pregnancy

A short course of postpartum furosemide helps improve postpartum blood pressure recovery in women with hypertensive disorders of pregnancy, especially those without severe disease, a study has shown.

The study randomized 384 women with gestational hypertension and pre-eclampsia with/without severe features to receive a 5-day course of 20-mg oral furosemide (n=192) or placebo (n=192). Efficacy was assessed with persistent hypertension at 7 days postpartum (generalized linear models to calculate adjusted relative risk) and days to resolution of hypertension (Kaplan-Meier curves), stratified by severity of hypertensive disease. Secondary endpoints included readmissions and need for additional hypertensive medication.

Baseline patient characteristics were comparable except caesarean delivery rate, which was higher in the furosemide group (29 percent vs 20 percent; p=0.04).

At treatment conclusion, furosemide produced a 60-percent reduction in the prevalence of persistently elevated blood pressure at 7 days on analysis controlling for caesarean delivery (adjusted relative risk, 0.40, 95 percent confidence interval [CI], 0.20–0.81). This benefit was more pronounced in women with nonsevere disease (adjusted relative risk, 0.26, 95 percent CI, 0.10–0.67).

Furthermore, blood pressure resolution occurred sooner among women with nonsevere disease who received furosemide (8.5 vs 10.5; p=0.001).

No significant between-group differences were seen in readmissions or need for additional antihypertensive medication postpartum.