Ketanserin for the treatment of preeclampsia

Objective: To compare maternal and perinatal outcome with the use of either intravenous ketanserin or dihydralazine in treatment of women with preecla mpsia. Methods: The records from January 1989 to January 1997 of all patients rece iving intravenous ketanserin or dihydralazine as first line antihypertensiv e therapy were reviewed and standardized data forms were completed. 315 cha rts of patients were identified and evaluated for effects on blood pressure . laboratory parameters, maternal and perinatal outcome. Results: During the study interval 169 patients received ketanserin and 146 dihydralazine. Significantly fewer antepartum (27% versus 38%, p = 0.04) a nd postpartum (25% versus 39%, p = 0.01) maternal complications were noted in patients receiving ketanserin. Occurrence of HELLP syndrome was signific antly lower among patients who received ketanserin (20%) than among those w ho received dihydralazine (40%, p = 0.0001). Side-effects were reported wit h significantly higher frequency in patients receiving dihydralazine (60%) as compared to those receiving ketanserin (17%,p < 0.0001). Perinatal outco me was comparable, however, umbilical cord arterial pH values (mean <plus/m inus> SD) were higher with ketanserin compared to dihydralazine (7.25 +/- 0 .07 vs 7.23 +/- 0.09,p = 0.038). The incidence of placental abruption was h igher in patients receiving dihydralazine (5.5%) versus those receiving ket anserin (0.6%, p = 0.014). Conclusion: Ketanserin appears to be a better option than dihydralazine for treatment of severe preeclampsia since fewer maternal complications and si de-effects were observed in patients receiving ketanserin.