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METHYLDOPA VERSUS NO DRUG TREATMENT IN THE MANAGEMENT OF MILD PREECLAMPSIA
Abstract
Objectives: To evaluate the efficacy of methyldopa in the treatment of mild pre-eclampsia,
to prevent its progress and to investigate its effect on the pregnancy outcomes.
Designs: Randomised clinical trial.
Setting: Wad Medani Hospital in the central Sudan.
Subjects: Seventy primigravidae with single, alive baby of 28-36 weeks gestational age
suffering from true mild pre-eclampsia were enrolled. The patients were randomised in two
groups, treatment group who received methyldopa 750- 4000 mg/day (n=34) and a control
group who received no treatment (n=36). All the (treatment and control) patients were drug
followed as in-patients till the delivery, seen with their babies on the days 7, 42 after the
delivery.
Main outcomes measures: The outcomes examined were, rise of the diastolic blood pressure
to 110 mm Hg or more, occurrence of imminent eclampsia or the eclampsia, if the maturity
could be achieved, occurrence of intrauterine growth retardation, abruptio placentae, mode
of delivery, birth weight, placental weight, perinatal death, Apgar score and referral of the
babies to the pediatrician.
Results: Three out of 34 (8.8%) of the treatment group had a rise in the diastolic blood
pressure of 110 mm Hg, 18/36(50%) of the control had a rise in the diastolic blood pressure
of 110 mmHg (p <0.05). Three out of thirty four (8.8%) of the treatment group developed
imminent eclampsia, while 10/36 (27.8) of the control group developed imminent eclampsia
(p<0.05). The maturity was achieved in 82.3% and 88.8% of the treatment and the control,
respectively (p > 0.05). There were ten (14.2%) perinatal deaths, four of them in the
treatment group, while six in the control (p > 0.05). There was no difference regarding birth
weight, occurrence of intrauterine growth retardation, placental weight, mode of delivery,
Apgar score, referral of the babies to the paediatrician. No patient developed eclampsia or
abruptio placenta; there was no maternal death in both groups.
Conclusion: Methyldopa can prevent the progress of the mild pre-eclampsia to severe preeclampsia,
without affecting the maturity, birthweight or the neonatal outcomes.
to prevent its progress and to investigate its effect on the pregnancy outcomes.
Designs: Randomised clinical trial.
Setting: Wad Medani Hospital in the central Sudan.
Subjects: Seventy primigravidae with single, alive baby of 28-36 weeks gestational age
suffering from true mild pre-eclampsia were enrolled. The patients were randomised in two
groups, treatment group who received methyldopa 750- 4000 mg/day (n=34) and a control
group who received no treatment (n=36). All the (treatment and control) patients were drug
followed as in-patients till the delivery, seen with their babies on the days 7, 42 after the
delivery.
Main outcomes measures: The outcomes examined were, rise of the diastolic blood pressure
to 110 mm Hg or more, occurrence of imminent eclampsia or the eclampsia, if the maturity
could be achieved, occurrence of intrauterine growth retardation, abruptio placentae, mode
of delivery, birth weight, placental weight, perinatal death, Apgar score and referral of the
babies to the pediatrician.
Results: Three out of 34 (8.8%) of the treatment group had a rise in the diastolic blood
pressure of 110 mm Hg, 18/36(50%) of the control had a rise in the diastolic blood pressure
of 110 mmHg (p <0.05). Three out of thirty four (8.8%) of the treatment group developed
imminent eclampsia, while 10/36 (27.8) of the control group developed imminent eclampsia
(p<0.05). The maturity was achieved in 82.3% and 88.8% of the treatment and the control,
respectively (p > 0.05). There were ten (14.2%) perinatal deaths, four of them in the
treatment group, while six in the control (p > 0.05). There was no difference regarding birth
weight, occurrence of intrauterine growth retardation, placental weight, mode of delivery,
Apgar score, referral of the babies to the paediatrician. No patient developed eclampsia or
abruptio placenta; there was no maternal death in both groups.
Conclusion: Methyldopa can prevent the progress of the mild pre-eclampsia to severe preeclampsia,
without affecting the maturity, birthweight or the neonatal outcomes.
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