Ketanserin and hydralazine in hypertension in pregnancy--a randomised double-blind trial.

Objectives: To compare ketanserin with hydralazine in the treatment of hypertension in late pregnancy.

Study Design: Randomised control trial. Ten milligrams ketanserin were compared with 5 mg hydralazine, both given intravenously to 10 patients in each group. Blood pressure, maternal and fetal heart rate and umbilical and arcuate artery Doppler flow velocimetry waveforms were recorded before and every 10 minutes after administration of the drug.

Results: No significant differences were found between the two drugs in respect of initial blood pressures and readings taken 10 minutes after each 30-minute administration. One patient in the hydralazine group developed severe hypotension and fetal distress for which a caesarean section was performed. No change in the flow velocity waveforms of umbilical and arcuate arteries was noticed.

Conclusion: No unforeseen complications followed the administration of ketanserin. No major differences in the effects of the two drugs could be detected. Ketanserin appears to be safer as no hypotension occurred, and it reduced blood pressure more gradually. As ketanserin could become an alternative to hydralazine, more studies with larger numbers of patients are needed to compare it with hydralazine.