American Journal of Obstetrics & Gynecology Mfm最新文献

{"title":"Severe maternal morbidity contributed by obstetric hemorrhage: Maryland, 2020-2022","authors":"Carrie Wolfson PHD ,&nbsp;Jessica Tsipe Angelson MS, CNM ,&nbsp;Robert Atlas MD ,&nbsp;Irina Burd MD, PHD ,&nbsp;Pamela Chin MS, PA-C ,&nbsp;Cathy Downey BSN, RN ,&nbsp;Jenifer Fahey CNM, PhD ,&nbsp;Susan Hoffman BSN ,&nbsp;Clark T. Johnson MD ,&nbsp;Monica B. Jones MD ,&nbsp;Kimberly Jones-Beatty DNP, MSN, CNM ,&nbsp;Jennifer Kasirsky MD ,&nbsp;Daniel Kirsch MD ,&nbsp;Ichchha Madan MD ,&nbsp;Donna Neale MD ,&nbsp;Joanne Olaku MSN ,&nbsp;Michelle Phillips BSN ,&nbsp;Amber Richter MSN ,&nbsp;Jeanne Sheffield MD ,&nbsp;Danielle Silldorff MS ,&nbsp;Andreea Creanga MD, PHD","doi":"10.1016/j.ajogmf.2024.101589","DOIUrl":"10.1016/j.ajogmf.2024.101589","url":null,"abstract":"<div><h3>Background</h3><div>Obstetric hemorrhage is the leading cause of maternal mortality and severe maternal morbidity (SMM) in Maryland and nationally. Currently, through a quality collaborative, the state is implementing the Alliance for Innovation on Maternal Health (AIM) patient safety bundle on obstetric hemorrhage.</div></div><div><h3>Objective</h3><div>To describe SMM events contributed by obstetric hemorrhage and their preventability in Maryland.</div></div><div><h3>Study Design</h3><div>This cross-sectional study used data from hospital-based SMM surveillance and review program in Maryland. Hospital-based SMM criteria include admission to an intensive care unit and/or transfusion of 4 or more units of blood products (of any type) during pregnancy or within 42 days postpartum. A total of 193 obstetric hemorrhage events that met the surveillance definition were identified in hospitals participating in SMM surveillance since inception on August 1, 2020 until December 31, 2022. We compared patient and delivery characteristics, practices done well, and recommendations for care improvement among patients with severe obstetric hemorrhage deemed preventable and non-preventable by hospital-based review committees. For obstetric hemorrhage events deemed preventable, we further identified factors that contributed to the SMM outcome at the provider, system, and patient levels.</div></div><div><h3>Results</h3><div>Uterine atony was the leading cause of obstetric hemorrhage events (37.8%), followed by uterine rupture, laceration and intra-abdominal bleeding (23.8%). Sixty-six (34.2%) obstetric hemorrhage events were preventable. Patients with preventable obstetric hemorrhage were significantly more likely to have an emergency than planned cesarean delivery and less likely to have a placental complication or &gt;1500 mL blood loss volume. Hospital-based review committees determined that 81.8%, 30.3%, and 22.7% of preventable events could have been prevented or made less severe through changes to provider, system, or patient factors, respectively. Recommendations following event reviews aligned with the Alliance for Innovation on Maternal Health Obstetric Hemorrhage Patient Safety Bundle, particularly regarding elements in the Recognition and Prevention and Response domains.</div></div><div><h3>Conclusion</h3><div>About one-third of SMM events contributed by obstetric hemorrhages were deemed preventable. Of AIM bundle elements, assessing hemorrhage risk on admission to labor and delivery, peripartum, and upon transition to postpartum care together with rapid, unit-standardized management of hemorrhage are likely to benefit more than half of patients with preventable SMM contributed by obstetric hemorrhage.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 2","pages":"Article 101589"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cesarean delivery classification system","authors":"Clodagh Mullen MD,&nbsp;Marcos Izquierdo MD,&nbsp;Nicolas Mas D' Alessandro MD,&nbsp;Matthew Sikora MD","doi":"10.1016/j.ajogmf.2025.101624","DOIUrl":"10.1016/j.ajogmf.2025.101624","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 4","pages":"Article 101624"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of GLP-1 medication exposure prior to, during, and after pregnancy using state-wide data from 2017 to 2023","authors":"Katherine A. Ahrens MPH, PhD,&nbsp;Kristin Palmsten ScD,&nbsp;Heather S. Lipkind MD, MS,&nbsp;Christina M. Ackerman-Banks MD","doi":"10.1016/j.ajogmf.2024.101596","DOIUrl":"10.1016/j.ajogmf.2024.101596","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 2","pages":"Article 101596"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative effectiveness of low molecular weight heparin on live birth for recurrent spontaneous abortion: systematic review and network meta-analysis","authors":"Wenrui Huang PhD ,&nbsp;Yue Yu BD ,&nbsp;Lei Chen MD ,&nbsp;Xiaoxuan Tang MD ,&nbsp;Xingzi Fang MD ,&nbsp;Xingyan Ou MD ,&nbsp;XueLian Du PhD","doi":"10.1016/j.ajogmf.2024.101572","DOIUrl":"10.1016/j.ajogmf.2024.101572","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the effectiveness and safety of low molecular weight heparins (LMWHs) on live birth rates and adverse pregnancy outcomes in individuals experiencing recurrent spontaneous abortion (RSA).</div></div><div><h3>Data sources</h3><div>PubMed, Web of Science, the Cochrane Library, and Embase from database inception to July 1, 2024.</div></div><div><h3>Study eligibility criteria</h3><div>Eligible randomized controlled trials enrolled women with RSA who received LMWH, with a follow-up duration of at least 12 weeks. The treatment was either monotherapy with LMWH or added LMWH to nonrandomized background anticoagulant treatments, with the control group being placebo and other anticoagulant treatments. Trials with a crossover design or involving withdrawn drugs were also excluded.</div></div><div><h3>Study appraisal and synthesis methods</h3><div>We assessed bias using the Risk of Bias 2.0 tool and evaluated evidence quality with the Confidence in Network Meta-Analysis framework. The network meta-analysis employed a Bayesian framework to integrate direct and indirect evidence, calculating risk ratios and 95% confidence intervals. Markov chain Monte Carlo methods generated posterior distributions, allowing comparison and ranking of treatments. Subgroup, regression, and sensitivity analyses assessed the impact of various factors on the results.</div></div><div><h3>Results</h3><div>This network meta-analysis included 22 trials involving 4773 participants across five different LMWH drugs, with all comparisons made against the control group. Among the five drugs, enoxaparin showed significant benefits. It notably improved live birth rates (LBR) (Risk Ratios 1.19, (95% confidence intervals 1.06 to 1.36), surface under the cumulative ranking curve 73%; moderate confidence of evidence), reduced the risk of pre-eclampsia (0.53, (0.28–0.92), 85%), lowered preterm delivery (0.59, [0.41–0.86], 85%), and decreased pregnancy loss (0.55, [0.38–0.76], 82%). Further analysis of 7 different LMWH doses revealed that both enoxaparin 20mg (1.53, [1.08–2.25], 89%) and 40mg (1.18, [1.04–1.38], 59%) significantly improved LBR, with the 20mg dose proving more effective. Both doses also significantly reduced the risk of pregnancy loss.</div></div><div><h3>Conclusion</h3><div>Enoxaparin proved to be the most effective LMWH in increasing LBR compared to the control group. It also significantly lowered the risks of pre-eclampsia, preterm delivery, and pregnancy loss. A dosage-based subgroup analysis showed that both 20mg and 40mg of enoxaparin improved LBR, with the 20mg dose demonstrating greater effectiveness.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 2","pages":"Article 101572"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal exome sequencing for the structurally normal fetus: ready or not?","authors":"Teresa N. Sparks MD, MAS","doi":"10.1016/j.ajogmf.2024.101513","DOIUrl":"10.1016/j.ajogmf.2024.101513","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 2","pages":"Article 101513"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High- vs low-dose oxytocin regimens for labor augmentation: a systematic review and meta-analysis","authors":"Teresa C. Logue MD, MPH ,&nbsp;Fabrizio Zullo MD ,&nbsp;Fiamma van Biema MA ,&nbsp;Moeun Son MD, MSCI ,&nbsp;Lauren London MD ,&nbsp;Sneha Paranandi MD ,&nbsp;Anthony C. Sciscione DO ,&nbsp;Giuseppe Rizzo MD ,&nbsp;Daniele Di Mascio MD ,&nbsp;Suneet P. Chauhan MD, Hon DSc","doi":"10.1016/j.ajogmf.2025.101604","DOIUrl":"10.1016/j.ajogmf.2025.101604","url":null,"abstract":"<div><h3>OBJECTIVE</h3><div>This study aimed to assess whether high- vs low-dose oxytocin regimens for labor augmentation are associated with differential risk of low Apgar score, neonatal acidosis, and other adverse labor outcomes.</div></div><div><h3>DATA SOURCES</h3><div>We searched electronic databases (MEDLINE, Embase, the Cochrane Library, CINAHL, Scopus, ClinicalTrials.gov) from inception up to March 2024 using combinations of the following key words: “oxytocin,” “oxytocin regimen,” “oxytocin protocol,” “oxytocin dosage,” “active management,” “high dose protocol,” “low dose protocol,” and “augmentation of labor.”</div></div><div><h3>STUDY ELIGIBILITY CRITERIA</h3><div>We included quasi-randomized and randomized controlled trials comparing continuous oxytocin infusion with high-dose regimens (intervention group) vs low-dose regimens (control group) in nulliparous or multiparous patients undergoing labor augmentation. High-dose regimens were defined as a starting oxytocin dose of ≥4 mU/min, increasing in increments of 3 to 7 mU/min every 15 to 40 minutes. Low-dose regimens were defined as a starting oxytocin dose of &lt;4 mU/min, increasing in increments of 1 to 2 mU/min every 15 to 40 minutes (PROSPERO CRD42024500197).</div></div><div><h3>METHODS</h3><div>The coprimary outcomes were incidence of Apgar score &lt;7 at 5 minutes and umbilical arterial pH &lt;7.00. The secondary outcomes included cesarean delivery and chorioamnionitis. We performed random-effects head-to-head meta-analyses to compare high-dose with low-dose strategies, and reported summary risk ratios with 95% confidence intervals.</div></div><div><h3>RESULTS</h3><div>Ten randomized and quasi-randomized controlled trials of 5508 pregnancies met the inclusion criteria and were included in this meta-analysis. There was no difference in risk for the coprimary outcomes of Apgar score &lt;7 at 5 minutes (relative risk, 0.94; 95% confidence interval, 0.60–1.46) and umbilical arterial pH &lt;7.00 (relative risk, 0.77; 95% confidence interval, 0.50–1.20). There was also no difference in risk for cesarean delivery (relative risk, 0.83; 95% confidence interval, 0.67–1.02). High-dose oxytocin regimens were associated with significantly lower risk of chorioamnionitis (relative risk, 0.70; 95% confidence interval, 0.57–0.84; number needed to treat=25) and higher risk of tachysystole (relative risk, 1.32; 95% confidence interval, 1.21–1.43; <em>P</em>&lt;.001).</div></div><div><h3>CONCLUSION</h3><div>When used for labor augmentation, high-dose oxytocin regimens decreased the risk of chorioamnionitis compared with low-dose regimens without affecting the risk of low Apgar scores, neonatal acidosis, or cesarean delivery.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 2","pages":"Article 101604"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labor roulette: the probability of achieving spontaneous labor in normal-risk nulliparous patients","authors":"Sarah M. Nicholson MB,&nbsp;Susan Hatt MSc,&nbsp;Corina I. Oprescu MD,&nbsp;Sara N. EL Nimr MB,&nbsp;Michael P. Geary MD,&nbsp;Patrick Dicker MSc,&nbsp;Zara E. Molphy PhD,&nbsp;Karen Flood MD,&nbsp;Fergal D. Malone MD","doi":"10.1016/j.ajogmf.2024.101590","DOIUrl":"10.1016/j.ajogmf.2024.101590","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 2","pages":"Article 101590"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of fixed time–interval and on-demand analgesia protocols for post–cesarean pain on maternal chronic pain and child development–follow-up of randomized controlled trial","authors":"Enav Yefet MD, PhD,&nbsp;Noa Frishman Martsiano MD,&nbsp;Ilanit Elbaz Shchory PhD,&nbsp;Zohar Nachum MD, MHA","doi":"10.1016/j.ajogmf.2024.101591","DOIUrl":"10.1016/j.ajogmf.2024.101591","url":null,"abstract":"","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 2","pages":"Article 101591"},"PeriodicalIF":3.8,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerclage in singleton pregnancies with no prior spontaneous preterm birth and short cervix: a randomized controlled trial","authors":"Rupsa C. Boelig MD ,&nbsp;Chiara Tersigni MD, PhD ,&nbsp;Nicoletta Di Simone MD, PhD ,&nbsp;Gabriele Saccone MD ,&nbsp;Fabio Facchinetti MD ,&nbsp;Giovanni Scambia MD ,&nbsp;Vincenzo Berghella MD","doi":"10.1016/j.ajogmf.2025.101602","DOIUrl":"10.1016/j.ajogmf.2025.101602","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;BACKGROUND&lt;/h3&gt;&lt;div&gt;Preterm birth remains a leading cause of neonatal morbidity and mortality. Cerclage for short cervical length ≤25 mm in patients with singleton pregnancies with a history of spontaneous preterm birth is associated with decreased neonatal morbidity/mortality. Both vaginal progesterone and cerclage individually have level 1 evidence supporting benefit in the prevention of preterm birth in pregnancies complicated by short cervical length. However, there is a paucity of level 1 evidence regarding the potential benefit of cerclage with progesterone relative to progesterone alone for short cervical length ≤25 mm in patients with singleton pregnancies without a history of spontaneous preterm birth.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;OBJECTIVE&lt;/h3&gt;&lt;div&gt;This study aimed to conduct a pragmatic randomized controlled trial to evaluate the additional benefit of cerclage with vaginal progesterone relative to vaginal progesterone alone in patients with singleton pregnancies without prior spontaneous preterm birth and with a current midtrimester transvaginal ultrasound cervical length ≤25 mm.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;STUDY DESIGN&lt;/h3&gt;&lt;div&gt;This was a multicenter international randomized controlled trial conducted from September 2017 to September 2023, involving 4 sites in the United States and Italy. Patients with singleton pregnancies without prior spontaneous preterm birth received transvaginal ultrasound cervical length (universal) screening during the midtrimester anatomy ultrasound examination as part of routine care. Inclusion criteria included transvaginal ultrasound cervical length ≤25 mm at 18 0/7 to 23 6/7 weeks. Exclusion criteria included current or planned cerclage, cervical dilation, symptoms of labor, infection, bleeding, and rupture of membranes at screening. Participants were randomized in a 1:1 ratio to cerclage with vaginal progesterone (200-mg vaginal progesterone daily) or vaginal progesterone alone. Randomization was stratified by study site and transvaginal ultrasound cervical length ≤15 mm. The primary outcome was preterm birth &lt;35 weeks, assessed using intention-to-treat analysis. Secondary outcomes included preterm birth &lt;37, 32, 28, and 24 weeks, gestational age at delivery, latency to delivery, and neonatal outcomes. Categorical variables were compared using the Pearson chi-square test and relative risk estimates with 95% confidence intervals. Continuous variables were compared using the Mann–Whitney U test. Latency to delivery and gestational age at delivery were also compared using Kaplan–Meier survival curves. Planned enrollment was set at N=206 on the basis of an estimated 0.54 relative risk with cerclage and a 34% incidence of preterm birth with standard care. The trial was registered on ClinicalTrials.gov (NCT03251729) on June 22, 2017.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;RESULTS&lt;/h3&gt;&lt;div&gt;Enrollment ran from September 22, 2017 to October 31, 2023, and was halted early because of lagging enrollment. A total of 93 participants were ","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 4","pages":"Article 101602"},"PeriodicalIF":3.8,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum furosemide for accelerating recovery in patients with preeclampsia: a randomized placebo-controlled trial","authors":"Telma Cursino MD, PhD ,&nbsp;Leila Katz MD, PhD ,&nbsp;Isabela Coutinho MD, PhD ,&nbsp;Alex Sandro Rolland de Souza MD, PhD ,&nbsp;Thais Valeria Silva MD, PhD ,&nbsp;Anna Catharina Carneiro da Cunha MD, MS ,&nbsp;Melania Amorim MD, PhD","doi":"10.1016/j.ajogmf.2025.101614","DOIUrl":"10.1016/j.ajogmf.2025.101614","url":null,"abstract":"<div><h3>BACKGROUND</h3><div>Preeclampsia is a major hypertensive disorder of pregnancy that may lead to severe complications, particularly in the first 2 weeks of the postpartum period. Blood pressure during the postpartum period remains high and often increases to levels higher than those observed during pregnancy. Furosemide, a fast-acting diuretic, reduces intravascular volume overload and may represent an alternative to accelerate the normalization of blood pressure levels.</div></div><div><h3>OBJECTIVE</h3><div>This study aimed to evaluate the effectiveness of furosemide compared with a placebo for blood pressure control in the postpartum period in women with severe preeclampsia.</div></div><div><h3>STUDY DESIGN</h3><div>In a triple-masked placebo-controlled randomized clinical trial, postpartum women with de novo preeclampsia with severe features or eclampsia diagnosed during pregnancy and adequate diuresis who had received magnesium sulfate were randomized to receive furosemide (40 mg/d orally for 5 days) or a placebo. The primary outcome was mean blood pressure. The secondary outcomes were frequency of severe hypertensive episodes, continued need for antihypertensives, number of antihypertensives used to control blood pressure, length of hospital stay, adverse effects, and maternal complications. A sample size of 120 patients was estimated, 60 in each arm of the study, based on the estimated difference between the mean systolic pressure of 142±12 mm Hg for the furosemide group and 153±19 mm Hg for the placebo group.</div></div><div><h3>RESULTS</h3><div>Between June 20, 2014, and November 30, 2014, 271 women were screened, and 120 were randomized to the furosemide or placebo groups, of which 118 were included in the final analysis (58 in the furosemide group and 60 in the placebo group). Most characteristics were similar between the groups. The mean daily systolic and diastolic pressures were lower in the furosemide group (<em>P</em>&lt;.001), and there were fewer episodes of severe hypertension on the second (<em>P</em>=.04) and fifth (<em>P</em>=.04) days of the postpartum period. In addition, a shorter time was required until blood pressure was controlled (<em>P</em>=.01) in the furosemide group.</div></div><div><h3>CONCLUSION</h3><div>Compared with placebo, 40 mg/d of oral furosemide in patients with preeclampsia reduced the mean daily systolic blood pressure in the first and fifth days of the postpartum period and mean daily diastolic blood pressure in the first, second, and fifth days of the postpartum period and the time required for blood pressure control.</div></div>","PeriodicalId":36186,"journal":{"name":"American Journal of Obstetrics & Gynecology Mfm","volume":"7 5","pages":"Article 101614"},"PeriodicalIF":3.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}