October 18, 2009

Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks’ gestation (HYPITAT): a multicentre, open-label randomised controlled trial

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This multicentre, open-label RCT examined whether induction of labor was superior to expectant management in pregnancies complicated by gestational hypertension or mild pre-eclampsia.

Related Articles:

Pregnancy and Hypertension/Renal Disease
  • P Shearing

    An interesting paper. As a Nephrologist, I occasionally am asked to see pregnant women with hypertension and proteinuria. I’d be very interested to see what our colleagues in Obstetrics think about this article. I am concerned that this article will increase obstetrical interventions based on an article that looked at a composite endpoint that included proteinuria and worsening hypertension. It seems that hard clinical endpoints (like infant/maternal outcomes) did not drive the statistically significant difference. So, we’d essentially be recommending early intervention to prevent outcomes such as progressive proteinuria/hypertension, which may have warranted intervention on their own.

    Reminds me a bit of the article

    Heparin plus Alteplase Compared with Heparin Alone in Patients with Submassive Pulmonary Embolism
    http://content.nejm.org/cgi/content/abstract/347/15/1143

    whereby thrombolyis in submassive PE seemed to reduce the combined endpoint which essentially was driven by the need for rescue thrombolysis.

    What do others think?