ORAL FUROSEMIDE FOR POSTPARTUM MANAGEMENT OF PATIENTS WITH PREGNANCY INDUCED HYPERTENSION

With Institutional Ethics Committee clearance and CTRI registration, 80 patients with the above-mentioned inclusion criteria will be recruited in the study.

Admission lists and in patient records will be screened daily to identify eligible patients. Women identified as having a hypertensive disorder of pregnancy will be invited to participate in the study. Protocol will be explained to all the patients and informed consent will be taken.

Relevant history, demographic data, eligibility, past and present medications, adverse event assessment and physical examination will be recorded.

Following randomization by a computer-generated sequence the trial group participants will receive oral furosemide 20 mg OD for the first 5 days of postpartum period with the first dose given with 8 hours of delivery. Patients will receive appropriate antihypertensives as per the hospital unit protocols and oral furosemide will only be an add on drug.  BP and significant clinical features of the trial and control groups will be recorded on the first 5 days and 6-week postnatal care (PNC) visit. Participants unable to visit the institution at 6 weeks postpartum will be encouraged to visit a primary health centre to obtain the BP readings.

Prompt treatment for elevated blood pressures will be initiated as soon as elevated blood pressures are recorded, and will not be delayed for study purposes including study drug administration. Medication used will be as per the treating clinician’s discretion.

There is minimal risk to use of furosemide in the postpartum period. Furosemide is a commonly used drug in postpartum period and prior studies have not shown any adverse effects in this patient population. Committee that overlooks adverse drug reactions at the the hospital who are not investigators on the trial will be utilized to monitor adverse outcomes. All serious adverse effect will be recorded and reported to the institutional review board.