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  • Title: The haemodynamic effects of ketanserin versus dihydralazine in severe early-onset hypertension in pregnancy.
    Author: Bolte AC, van Eyck J, Strack van Schijndel RJ, van Geijn HP, Dekker GA.
    Journal: Br J Obstet Gynaecol; 1998 Jul; 105(7):723-31. PubMed ID: 9692412.
    Abstract:
    OBJECTIVE: To compare the haemodynamic efficacy of ketanserin (a selective serotonin2-receptor blocker) with dihydralazine in the management of severe early-onset hypertension in pregnancy. DESIGN: Subgroup analysis within a randomised prospective multicentre trial to compare haemodynamic effects as measured by pulmonary artery catherization. SETTING: Departments of Obstetrics and Gynaecology and Intensive Care Medicine, Free University Hospital, Amsterdam and Sophia Hospital, Zwolle. PARTICIPANTS: Thirty-one women with a diastolic blood pressure > 110 mmHg and a gestational age between 26 and 32 weeks. RESULTS: The antihypertensive efficacy of both drugs was comparable. Dihydralazine significantly increased cardiac output (P < 0.01), while ketanserin induced only minor changes in cardiac output. Systemic vascular resistance decreased in both groups, but the decrease was significantly more pronounced with dihydralazine compared with ketanserin. Ketanserin induced a significant but not clinically relevant increase in heart rate (P < 001, while dihydralazine caused marked tachycardia (P < 0.005). Left ventricular stroke work index was reduced to similar values in both groups. CONCLUSIONS: The antihypertensive profile of ketanserin is characterised by an early and gradual reduction of blood pressure in combination with a moderate decrease in systemic vascular resistance and no significant change in cardiac output. Dihydralazine causes market tachycardia resulting in a considerable increase in cardiac output.
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