Table 2
Primary outcome and safety data reporting in included studies
| Study ID | Intervention | Control | Primary outcome assessment | Safety data reporting | Results (for reported outcomes) | ||||
| Maternal mortality | Maternal morbidity | SBP control | DBP control | MAP control | |||||
| (A) Antihypertensive medications, 18 studies | |||||||||
| Calcium-channel blockers (three studies) | |||||||||
| Barton et al 32 | Nifedipine (oral) | Placebo |
|
|
| SBP control: no significant difference DBP control: no significant difference MAP control: improved in intervention group (difference 6.3 mm Hg, P<0.05) | |||
| Vermillion et al 21 | Nifedipine (oral) | Labetalol (intravenous bolus) |
|
|
| SBP control: improved in intervention group (difference in time to target BP 18.5 min, P=0.002) DBP control: improved in intervention group (difference in time to target BP 18.5 min, P=0.002) Safety: no significant difference; 1/25 intervention group became hypotensive | |||
| Sayin et al 34 | Nifedipine (oral) | Methyldopa (oral) |
|
|
| Maternal mortality: no significant difference SBP control: no significant difference DBP control: no significant difference | |||
| Vasodilators (6 studies) | |||||||||
| Palot et al 36 | Hydralazine (intravenous infusion) plus furosemide (intravenous bolus) | Clonidine (intravenous) plus furosemide (intravenous bolus) |
| Maternal morbidity: no statistical analysis | |||||
| Griffis et al 38 39 | Hydralazine (intramuscular) | Methyldopa (intravenous bolus) |
|
| MAP control: no significant difference Safety: no significant difference; no side effects reported in either group | ||||
| Walss Rodríguez et al 40 | Hydralazine (oral) plus nifedipine (oral, as required) | Nifedipine (oral, as required) |
|
| SBP control: no significant difference DBP control: no significant difference | ||||
| Begum et al 17 | Hydralazine (intravenous bolus) | Hydralazine (intravenous infusion) |
|
| DBP control: improved in intervention group (difference in time to target DBP 121.1 min, P<0.001) Safety: no significant difference; no side effects reported in either group | ||||
| Vigil-De Gracia et al 35 | Hydralazine (intravenous bolus) | Labetalol (intravenous bolus) |
|
|
|
|
| Maternal mortality: no significant difference Maternal morbidity: no significant difference SBP control: no significant difference DBP control: no significant difference Safety: no significant difference; small numbers of side effects reported in both groups | |
| Hennessy et al 23 | Diazoxide (intravenous bolus) | Hydralazine (intravenous bolus) |
|
| SBP control: improved in intervention group (difference in percentage achieving target BP 23%, P<0.01) DBP control: improved in intervention group (difference in percentage achieving target BP 23%, P<0.01) | ||||
| Beta-blockers (5 studies) | |||||||||
| Garden et al 24 | Labetalol (intravenous infusion) | Dihydralazine (intravenous infusion) |
|
| DBP control: no statistical analysis Safety: no statistical analysis; 1/6 intervention group developed bronchospasm; 4/6 control group developed tachycardia and 1/6 developed oliguria; 4/6 control group, drug stopped due to a precipitous fall of DBP to 40–50 mm Hg | ||||
| Fidler et al 42 | Timolol (oral) | Methyldopa (oral) |
|
|
| SBP control: improved in intervention group (difference 5.1 mm Hg, P<0.05) DBP control: no significant difference Safety: no statistical analysis; 1/40 intervention group became disorientated; 1/40 control group became hypotensive and 1/40 became drowsy | |||
| Mabie et al 22 | Labetalol (intravenous bolus) | Hydralazine (intravenous bolus) |
|
| MAP control: improved in control group (difference 7.8 mm Hg, P=0.02) Safety: no statistical analysis; 1/40 intervention group developed scalp tingling; 2/20 control group developed headaches | ||||
| Shumard et al 41 | Labetalol (oral) | Nifedipine (oral) |
|
| SBP control: improved in control group (difference in time to achieve target BP 1 day, P=0.0031) DBP control: improved in control group (difference in time to achieve target BP 1 day, P=0.0031) | ||||
| Sharma et al 27 28 | Labetalol (oral) | Nifedipine (oral) |
|
|
| SBP: no significant difference DBP: no significant difference Safety: no major side effects reported in either group; minor side effects more commonly reported in control group (20% intervention, 48% control, P=0.04) | |||
| Thiazides (2 studies) | |||||||||
| Gaisin et al 25 | Indapamide (oral) | Methyldopa (oral) |
|
|
| SBP control: no significant difference DBP control: no significant difference Safety: no statistical analysis, no details reported | |||
| Ilshat Gaisin et al 37 | Indapamide (oral) plus ursodeoxycholic acid (oral) | Methyldopa (oral) |
|
|
| SBP control: no significant difference DBP control: no significant difference Safety: no significant difference; no adverse events reported in either group | |||
| Indole alkaloids (1 study) | |||||||||
| Krebs43 44 | Reserpine (oral or intramuscular) | Phenobarbital |
|
|
| SBP control: no statistical analysis DBP control: no statistical analysis Safety: no statistical analysis; no adverse events reported in intervention group, no comment on control | |||
| Centrally acting alpha agonists (1 study) | |||||||||
| Noronha Neto et al 29–31 | Clonidine (oral) | Captopril (oral) |
|
|
|
|
| Maternal mortality: no significant difference Maternal morbidity: no significant difference SBP control: improved in intervention group (difference in number of episodes of high BP (1.4, P<0.08) DBP: improved in intervention group (difference in number of episodes of high BP (1.4, P<0.08) Safety: no significant difference; adverse reactions 18.6% intervention, 28.8% control, P=NS | |
| (B) Loop diuretics, other drugs, uterine curettage and organisation of care, 21 studies | |||||||||
| Loop diuretics (4 studies) | |||||||||
| Matthews et al 46 | Furosemide (oral) | Placebo |
| MAP control: no significant difference | |||||
| Ascarelli et al 16 | Furosemide (oral) | No intervention |
|
|
| Maternal morbidity: no significant difference SBP control: no significant difference DBP control: no significant difference | |||
| Amorim et al 45 | Furosemide (oral) | Placebo |
|
|
| SBP control: improved in intervention group (difference not stated, P<0.001) DBP control: improved in intervention group (difference not stated, P<0.001) MAP control: improved in intervention group (difference not stated, P<0.001) | |||
| Veena et al 19 | Furosemide (oral)+nifedipine (oral) | Nifedipine (oral) |
|
|
|
| Maternal morbidity: no significant difference SBP control: no significant difference DBP control: no significant difference MAP control: no significant difference | ||
| Other drugs (7 studies) | |||||||||
| Selective 5-HT antagonists | |||||||||
| Weiner48 | R41468 (intravenous infusion) | Placebo |
| MAP control: improved in intervention group (difference 25.6 mm Hg, P<0.001) | |||||
| Weiner et al 49 | Ketanserin (intravenous infusion) | Placebo |
|
|
|
| SBP control: improved in intervention group (difference in SBP decline 34 mm Hg, P<0.001) DBP control: improved in intervention group (difference in DBP decline 27 mm Hg, P<0.001) MAP control: improved in intervention group (difference not stated, P<0.001) Safety: no statistical analysis; 3/20 intervention group experienced blurred vision, 1 of these was hypotensive (responded to hydration); 1/20 intervention group experienced mild euphoria | ||
| Montenegro et al 50 | Ketanserin (intravenous bolus+/− infusion) | Placebo |
|
|
| SBP control: improved in intervention group (absolute difference not stated, P<0.001) DBP control: improved in intervention group (absolute difference not stated, P<0.001) MAP control: improved in intervention group (absolute difference not stated, P<0.001) | |||
| Alternative therapies | |||||||||
| Hladunewich et al 51 | L-arginine (oral or intravenous bolus) | Placebo |
|
|
|
| SBP control: no significant difference DBP control: no significant difference MAP control: no significant difference Safety: no significant difference; no adverse events reported in either group | ||
| Liu et al 52 | Shengkangbao (oral or intravenous bolus) | No intervention |
|
| SBP control: no significant difference DBP control: no significant difference | ||||
| Steroids | |||||||||
| Barrilleaux et al 53 54 | Dexamethasone (intravenous bolus) | Placebo |
| MAP control: no significant difference | |||||
| Atrial natriuretic peptide | |||||||||
| Shigemitsu et al 47 | Carperitide (route not specified) | No intervention |
|
|
| Maternal mortality: no significant difference MAP control: no significant difference Safety: no significant difference; no adverse events reported in either group | |||
| Uterine curettage (8 studies) | |||||||||
| Salvatore et al 58 | Uterine curettage | No intervention |
|
|
| Maternal morbidity: no statistical analysis SBP control: no statistical analysis DBP control: no statistical analysis | |||
| Magann et al 59 | Uterine curettage | No intervention |
|
| MAP control: improved in intervention group (difference at different time points to 24 hours postpartum 6–10 mm Hg, P<0.05) Safety: no significant difference; no complications reported from intervention (follow-up to 7 weeks postpartum) | ||||
| Magann et al 60 | Uterine curettage | Nifedipine (oral) or no intervention |
|
| MAP control: no significant difference between intervention and oral nifedipine; improved in intervention group compared with no intervention (difference at 8–48 hour postpartum 9–13 mm Hg, P=0.0017) Safety: no significant difference; no complications/side effects reported from interventions (follow-up to 7 weeks postpartum) | ||||
| Gocmen et al 57 | Uterine curettage | No intervention |
| MAP control: improved in intervention group (difference not stated, P=0.01) | |||||
| Gomez et al 61 | Uterine curettage | No intervention |
|
| MAP control: improved in intervention group (difference not stated, P<0.001) Safety: no significant difference; no complications reported from intervention | ||||
| Alkan et al 62 | Uterine curettage | No intervention |
|
| MAP control: improved in intervention group (difference 6.8 mm Hg, P<0.05) Safety: no significant difference; no complications reported from intervention | ||||
| Ragab et al 15 | Uterine curettage | No intervention |
|
|
| Maternal mortality: no significant difference Maternal morbidity: no statistical analysis MAP control: improved in intervention group (difference at 6 hour postpartum 12.3 mm Hg, P=0.02; difference at 24 hours postpartum, 9.2 mm Hg, P=0.01) | |||
| Mallapur et al 18 | Uterine curettage | No intervention |
| MAP control: improved in intervention group (difference at 4 hour postpartum 7.6 mm Hg, P<0.001). | |||||
| Organisation of care (2 studies) | |||||||||
| York et al 26 | Nurse specialist follow-up | No intervention | NA | ||||||
| Bibbo et al 33 | Specialist postpartum clinic | No intervention | NA | ||||||
For primary outcome assessment where there was a significant difference between groups, the magnitude of the difference is reported; where any adverse events or side effects were reported, this is presented.
=improved in intervention group; =no significant difference; =improved in control group; =unclear.5-HT, 5-hydroxytryptamine; BP, blood pressure; DBP, diastolic blood pressure; MAP, mean arterial pressure; NA, not applicable; NS, non-significant; SBP, systolic blood pressure.
