12What investigations, monitoring and advice should be given to women with hypertensive disorders of pregnancy, especially for those who wish to breastfeed, following discharge from critical care level 2/3?

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What investigations, monitoring and treatment should be given to women with hypertensive disorders of pregnancy in the postnatal period, especially those discharged from critical care level 2/3?

How should women who were hypertensive in pregnancy, who wish to breastfeed, be managed in the postnatal period?

Reference IDBibliographic InformationReason for rejecting study
603Authors: Levitan AA;Manion JC;. Title: Propranolol therapy during pregnancy and lactation. Journal Name: American Journal of Cardiology. Year: 1973 AugLetter
604Authors: Jonas W;Nissen E;Ransjo-Arvidson AB;Wiklund I;Henriksson P;Uvnas-Moberg K;. Title: Short- and long-term decrease of blood pressure in women during breastfeeding. Journal Name: Breastfeeding Medicine. Year: 2008Study investigating breastfeeding effect on the level of blood pressure. Outside the predefined interventions for this question.
605Authors: Tunstall ME;Campbell DM;Dawson BM;Jostell KG;. Title: Chlormethiazole treatment and breast feeding. Journal Name: British Journal of Obstetrics and Gynaecology. Year: 1979 OctCase report: intervention is outside predefined interventions for this question.
606Authors: Ghanem FA;Movahed A;. Title: Use of antihypertensive drugs during pregnancy and lactation. Journal Name: Cardiovascular therapeutics. Year: 2008Review article
607Authors: White WB;. Title: Management of hypertension during lactation. Journal Name: Hypertension. Year: 1984 MayReview article
608Authors: Hebert MF;Carr DB;Anderson GD;Blough D;Green GE;Brateng DA;Kantor E;Benedetti TJ;Easterling TR;. Title: Pharmacokinetics and pharmacodynamics of atenolol during pregnancy and postpartum. Journal Name: Journal of Clinical Pharmacology. Year: 2005 JanAtenolol pharmacokinetics study
609Authors: Ellsworth A;. Title: Pharmacotherapy of hypertension while breastfeeding. Journal Name: Journal of Human Lactation. Year: 1994 JunReview article
610Authors: Haldeman W;. Title: Can magnesium sulfate therapy impact lactogenesis?. Journal Name: Journal of Human Lactation. Year: 1993 DecIntervention is outside predefined interventions for this question.
611Authors: Leeners B;Rath W;Kuse S;Neumaier-Wagner P;. Title: Breast-feeding in women with hypertensive disorders in pregnancy. Journal Name: Journal of Perinatal Medicine. Year: 2005Breast-feeding prevalence amongst women with hypertensive disorders (outside the predefined interventions for this question).
612Authors: Watson DL;Bhatia RK;Norman GS;Brindley BA;Sokol RJ;. Title: Bromocriptine mesylate for lactation suppression: A risk for postpartum hypertension?. Journal Name: Obstetrics and Gynecology. Year: 1989Bromocriptine as a risk factor for postpartum hypertension. Outside the predefined interventions for this question.
613Authors: Magee L;Sadeghi S;. Title: Prevention and treatment of postpartum hypertension. Journal Name: Cochrane Database of Systematic Reviews. Year: 2008All trials included in this review were considered separately for this question.
614Authors: Karlberg B;Lundberg D;Aberg H;. Title: Letter: Excretion of propranolol in human breast milk. Journal Name: Acta Pharmacologica et Toxicologica. Year: 1974 MarLetter
615Authors: Jones HM;Cummings AJ;. Title: A study of the transfer of alpha-methyldopa to the human foetus and newborn infant. Journal Name: British Journal of Clinical Pharmacology. Year: 1978 NovLetter
616Authors: Sandstrom B;Regardh CG;. Title: Metoprolol excretion into breast milk. Journal Name: British Journal of Clinical Pharmacology. Year: 1980Letter
617Authors: Regardh CG;Johnsson G;. Title: Clinical pharmacokinetics of metoprolol. Journal Name: Clinical Pharmacokinetics. Year: 1980Review article
618Authors: Devlin RG;Duchin KL;Fleiss PM;. Title: Nadolol in human serum and breast milk. Journal Name: British Journal of Clinical Pharmacology. Year: 1981Intervention is outside the predefined interventions for this question
619Authors: Krause W;Stoppelli I;Milia S;Rainer E;. Title: Transfer of mepindolol to newborns by breast-feeding mothers after single and repeated daily doses. Journal Name: European Journal of Clinical Pharmacology. Year: 1982Intervention is outside the predefined interventions for this question
620Authors: Fidler J;Smith V;De S;. Title: Excretion of oxprenolol and timolol in breast milk. Journal Name: British Journal of Obstetrics and Gynaecology. Year: 1983Intervention is outside the predefined interventions for this question
621Authors: Boutroy MJ;Bianchetti G;Dubruc C;. Title: To nurse when receiving acebutolol: Is it dangerous for the neonate?. Journal Name: European Journal of Clinical Pharmacology. Year: 1986Intervention is outside the predefined interventions for this question
622Authors: Anderson P;Bondesson U;Mattiasson I;Johansson BW;. Title: Verapamil and norverapamil in plasma and breast milk during breast feeding. Journal Name: European Journal of Clinical Pharmacology. Year: 1987Intervention is outside the predefined interventions for this question
623Authors: Huttunen K;Gronhagen-Riska C;Fyhrquist F;. Title: Enalapril treatment of a nursing mother with slightly impaired renal function. Journal Name: Clinical Nephrology. Year: 1989Letter
624Authors: Martin JN;Files JC;Blake PG;Perry KG;Morrison JC;Norman PH;. Title: Postpartum plasma exchange for atypical preeclampsia-eclampsia as HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome.[see comment]. Journal Name: American Journal of Obstetrics and Gynecology. Year: 1995 AprPlasma exchange for postpartum HELLP. Outside the predefined interventions for this question.
625Authors: Mantel GD;Makin JD;. Title: Low dose dopamine in postpartum pre-eclamptic women with oliguria: a double-blind, placebo controlled, randomised trial. Journal Name: British Journal of Obstetrics and Gynaecology. Year: 1997 OctRCT, no useful outcomes.
626Authors: Alkan A;Tugrul S;Oral O;Uslu H;Kose D;Catakli FT;. Title: Effects of postpartum uterine curettage on maternal well-being in severe preeclamptic patients. Journal Name: Clinical and Experimental Obstetrics and Gynecology. Year: 2006Postpartum uterine curettage for severe pre-eclampsia. Outside the predefined interventions for this question.
627Authors: Keiseb J;Moodley J;Connolly CA;. Title: Comparison of the efficacy of continuous furosemide and low-dose dopamine infusion in preeclampsia/eclampsia-related oliguria in the immediate postpartum period. Journal Name: Hypertension in Pregnancy. Year: 2002RCT studying severe preelcampsia/eclampsia related oliguria in the immediate postpartum period. No useful outcomes reported.
628Authors: Gilboa Y;Bardin R;Feldberg D;Bachar GN;. Title: Postpartum hepatic rupture and retroperitoneal hematoma associated with HELLP syndrome. Journal Name: Israel Medical Association Journal: Imaj. Year: 2006 MarCase report
629Authors: Roes EM;Raijmakers MT;Schoonenberg M;Wanner N;Peters WH;Steegers EA;. Title: Physical well-being in women with a history of severe preeclampsia. Journal Name: Journal of Maternal-Fetal and Neonatal Medicine. Year: 2005 JulThis study does not investigate any of the pre-defined interventions or investigations.
630Authors: Detti L;Mecacci F;Piccioli A;Ferrarello S;Carignani L;Mello G;Ferguson JE;Scarselli G;. Title: Postpartum heparin therapy for patients with the syndrome of hemolysis, elevated liver enzymes, and low platelets (HELLP) is associated with significant hemorrhagic complications. Journal Name: Journal of Perinatology. Year: 2005 AprHeparin for HELLP syndrome. Outside the predefined interventions for this question.
631Authors: Magann EF;Bass JD;Chauhan SP;Perry KG;Morrison JC;Martin JN;. Title: Accelerated recovery from severe preeclampsia: uterine curettage versus nifedipine. Journal Name: Journal of the Society for Gynecologic Investigation. Year: 1994 JulPostpartum uterine curettage vs. nifedipine for pre-eclampsia. Outside the predefined interventions for this question.
632Authors: Ehrenberg HM;Mercer BM;. Title: Abbreviated postpartum magnesium sulfate therapy for women with mild preeclampsia: a randomized controlled trial.[see comment]. Journal Name: Obstetrics and Gynecology. Year: 2006 OctIntervention is outside predefined interventions for this question.
633Authors: Barrilleaux PS;Martin JN;Klauser CK;Bufkin L;May WL;. Title: Postpartum intravenous dexamethasone for severely preeclamptic patients without hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome: a randomized trial. Journal Name: Obstetrics and Gynecology. Year: 2005 AprDexamethasone for pre-eclampsia without HELLP. Outside the predefined interventions for this question.
634Authors: Alfirevic Z;Mousa HA;Martlew V;Briscoe L;Perez-Casal M;Toh CH;. Title: Postnatal screening for thrombophilia in women with severe pregnancy complications. Journal Name: Obstetrics and Gynecology. Year: 2001 MayPopulation: severe pregnancy complications. Outside the predefined population for this question.
635Authors: Magann EF;Martin JN;Isaacs JD;Perry KG;Martin RW;Meydrech EF;. Title: Immediate postpartum curettage: accelerated recovery from severe preeclampsia. Journal Name: Obstetrics and Gynecology. Year: 1993 AprPostpartum uterine curettage for severe pre-eclampsia. Outside the predefined interventions for this question.
636Authors: van Pampus MG;Koopman MM;Wolf H;Buller HR;Prins MH;van den EA;. Title: Lipoprotein(a) concentrations in women with a history of severe preeclampsia--a case control study. Journal Name: Thrombosis and Haemostasis. Year: 1999 JulOutside the predefined interventions for this question.
565Authors: Mecacci F;Carignani L;Cioni R;Parretti E;Mignosa M;Piccioli A;Scarselli G;Mello G;. Title: Time course of recovery and complications of HELLP syndrome with two different treatments: heparin or dexamethasone. Journal Name: Thrombosis Research. Year: 2001 Apr 15Heparin vs. dexamethasone for HELLP syndrome. Outside the predefined interventions for this question.
613Authors: Magee L;Sadeghi S;. Title: Prevention and treatment of postpartum hypertension. Journal Name: Cochrane Database of Systematic Reviews. Year: 2008All studies included in this review were considered and included individually.
637Authors: Gates S;Brocklehurst P;Davis LJ;. Title: Prophylaxis for venous thromboembolic disease in pregnancy and the early postnatal period. Journal Name: Cochrane Database of Systematic Reviews. Year: 2008Participants: women who are pregnant or within 6 weeks of birth, no hypertensive disorders in pregnancy.
508Authors: Montenegro R;Knuppel RA;Shah D;O'Brien WF;. Title: The effect of serotonergic blockade in postpartum preeclamptic patients. Journal Name: American Journal of Obstetrics and Gynecology. Year: 1985 SepRCT with cross over with placebo (number of patients in each treatment arm is unknown). No clinical outcomes reported.
638Authors: Belfort MA;Moore PJ;. Title: Verapamil in the treatment of severe postpartum hypertension. Journal Name: South African Medical Journal. Year: 1988 Sep 17Non-comparative trial
639Authors: Barrilleaux PS;Martin JM Jr;Klauser C;Bufkin L;May W;. Title: Adjunctive intravenous dexamethasone in patients with severe preelcampsia not complicated by HELLP syndrome. Journal Name: American Journal of Obstetrics and Gynecology. Year: 2003Abstract
640Authors: Isler CM;Barrilleaux PS;Rinehart BK;Magann EF;Martin JN; Title: Repeat postpartum magnesium sulfate 4 administration for seizure prophylaxis: is there a patient profile predictive of need for 5 additional therapy? Journal of Maternal-Fetal and Neonatal Medicine 2002; 11:(2)75–9.This study is not relevant to UK practice as half the threshold for giving magnesium sulphate is much lower than in the UK. This study is about prediction – not effectiveness.

From: Appendix F, Excluded studies

Cover of Hypertension in Pregnancy
Hypertension in Pregnancy: The Management of Hypertensive Disorders During Pregnancy.
NICE Clinical Guidelines, No. 107.
National Collaborating Centre for Women's and Children's Health (UK).
London: RCOG Press; 2010 Aug.
Copyright © 2011, Royal College of Obstetricians and Gynaecologists.

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