Background: Hypertensive disorders in pregnancy could persist postpartum, or appear for the first time after delivery and could require a pharmacological treatment. It was found no evidence in literature about what therapy should be used in puerperal hypertension. Objectives: To determine the effective therapy for the treatment of high postpartum systemic arterial blood pressure in women with hypertension in pregnancy or in women with de novo hypertension. Data sources: Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CCRCT), Embase, Medline, Pubmed Study eligibibility criteria, partecipants and interventions: Postnatal women with hypertension. Therapeutic treatment for management of hypertension compared with placebo or no therapy. Esclusion of preeclampsia/eclampsia. Study appraisal and synthesis methods: Results: 23 studies were included (n=23). Limitations: - Randomised controlled studies plus other experimental study designs (cohort studies, case– control studies and quasi-randomised studies) were included, and no limitations were imposed in terms of language or publication date, resulting in a comprehensive review. - This review highlights significant evidence gaps, demonstrating that further comparative research is required, particularly to clarify postpartum antihypertensive selection. Conclusions: There are insufficient evidence to recommend a particular therapy or model of care, but calcium channel blockers, beta blockers, alpha blockers and Angiotensin converting enzyme inhibitors (ACEIs) appeared variably effective. Key findings: Severe preeclampsia, Hypertension, Pregnancy, Postpartum, Very high blood pressure, Antihypertensive therapy

Clinical management of hypertensive disorders in postpartum women. A narrative review / Scudo, Maria; Petruzziello, Luciano; Carbone, Fabiana; Logoteta, Alessandra; Paoni Saccone, Giulia; D'Oria, Ottavia; Galoppi, Paola; Brunelli, Roberto; Monti, Marco. - In: MINERVA OBSTETRICS AND GYNECOLOGY. - ISSN 2724-6450. - (2021). [10.23736/S2724-606X.21.04733-3]

Clinical management of hypertensive disorders in postpartum women. A narrative review

Scudo, Maria;Petruzziello, Luciano;Carbone, Fabiana
;
Logoteta, Alessandra;Paoni Saccone, Giulia;D'Oria, Ottavia;Galoppi, Paola;Brunelli, Roberto;Monti, Marco
2021

Abstract

Background: Hypertensive disorders in pregnancy could persist postpartum, or appear for the first time after delivery and could require a pharmacological treatment. It was found no evidence in literature about what therapy should be used in puerperal hypertension. Objectives: To determine the effective therapy for the treatment of high postpartum systemic arterial blood pressure in women with hypertension in pregnancy or in women with de novo hypertension. Data sources: Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CCRCT), Embase, Medline, Pubmed Study eligibibility criteria, partecipants and interventions: Postnatal women with hypertension. Therapeutic treatment for management of hypertension compared with placebo or no therapy. Esclusion of preeclampsia/eclampsia. Study appraisal and synthesis methods: Results: 23 studies were included (n=23). Limitations: - Randomised controlled studies plus other experimental study designs (cohort studies, case– control studies and quasi-randomised studies) were included, and no limitations were imposed in terms of language or publication date, resulting in a comprehensive review. - This review highlights significant evidence gaps, demonstrating that further comparative research is required, particularly to clarify postpartum antihypertensive selection. Conclusions: There are insufficient evidence to recommend a particular therapy or model of care, but calcium channel blockers, beta blockers, alpha blockers and Angiotensin converting enzyme inhibitors (ACEIs) appeared variably effective. Key findings: Severe preeclampsia, Hypertension, Pregnancy, Postpartum, Very high blood pressure, Antihypertensive therapy
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11573/1646123
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