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

    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?