Ketanserin versus dihydralazine in the management of severe early-onset preeclampsia: Maternal outcome

OBJECTIVE: An open, randomized, prospective, multicenter trial was conducte d to compare the efficacy and safety of intravenous ketanserin, a selective serotonin 2 receptor blocker, with that of intravenous dihydralazine in th e management of severe early-onset (<32 weeks gestation) preeclampsia. End points of this study were blood pressure control and maternal outcome. STUDY DESIGN: Patients with a diastolic blood pressure >110 mm Hg were rand omly assigned to receive either ketanserin (n = 22) or dihydralazine (n = 2 2) as initial therapy. Plasma volume expansion preceded antihypertensive tr eatment, which was administered according to a fixed schedule. RESULTS: The reductions in blood pressure with the 2 drugs were similar; ho wever, adequate blood pressure control was reached significantly earlier wi th ketanserin (84 +/- 63 vs 171 +/- 142 minutes, P = .017). Occurrence of m aternal complications was significantly lower among patients who received k etanserin than among patients who received dihydralazine (n = 6 vs n = 18, P = .0007). A significant difference in favor of ketanserin was noted in da ily fluid balance. CONCLUSION: Antihypertensive efficacies of ketanserin and dihydralazine wer e comparable, but significantly fewer maternal complications were noted amo ng the patients receiving ketanserin. Ketanserin is an attractive alternati ve in the management of severe early-onset preeclampsia.