• J Moodley and E Gouws.
• Faculty of Medicine, University of Natal Durban, South Africa.
• Br J Obstet Gynaecol. 1992 Sep 1;99(9):727-30.

ObjectiveTo compare the antihypertensive effects of epoprostenol sodium (prostacyclin) with that of dihydralazine in acute hypertensive crises of pregnancy.DesignA prospective randomized study. A minimum of 20 patients per group was considered statistically acceptable (alpha = 0.05, power = 0.9).SettingA large urban tertiary hospital.SubjectsForty-seven pregnant patients with diastolic blood pressures of > 100 mmHg were studied.InterventionLowering of high blood pressure with either dihydralazine (n = 25), the standard drug for this purpose, or epoprostenol (n = 22).Main Outcome MeasureA significant drop in high blood pressure was regarded as a fall of 15 mmHg diastolic and 30 mmHg systolic blood pressure.ResultsThere were no statistically significant differences in the antihypertensive effects between the two treatment groups. Epoprostenol infusion caused less tachycardia; the mean pulse rate changed from 81.77 beats/min, before treatment to 88.36 at stabilization, compared with a change from 80.96 beats/min to 102.68 in the group treated with dihydralazine (P = 0.0024).ConclusionThe place of epoprostenol in pregnancy might be in patients with severe hypertension and tachycardia and in those requiring acute control of severe hypertension on the operating table before general anaesthesia.

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