Abstract
Objectives In addition to blood pressure control, postpartum control of urine output is a major issue in hypertensive pregnancy, HELLP syndrome or placental abruption. Delayed diuresis after delivery may easily cause abdominal dropsy, pulmonary edema, or late-onset renal failure. We recently added a new medicine, carperitide (atrial natriuretic peptide, hANP®), in addition to standard diuretic, like furosemide, for diuresis in such severe postpartum conditions. The objective of this study was to reveal the clinical and cost effectiveness of use carperitide in postpartum intensive care after preeclampsia. Methods Medical records of the patients who were administered carperitide in Nara Medical University Hospital after delivery or cesarean section for severe preeclampsia, HELLP syndrome and placental abruption were reviewed. Six patients who used carperitide were compared with ten patients who did not. Duration between delivery or administration of carperitide and maternal massive diuresis were retrieved as well as background, maternal outcome, duration of stay in hospital and blood pressure. Results There have been no maternal deaths or the need for artificial dialysis after these diseases for recent five years. Use of carperitide significantly decreased maternal mean blood pressure after 48 h of operation and shortened the duration between delivery or cesarean section and massive diuresis. No adverse effect was defined. Conclusions Though it was not a randomized, controlled study, in the intensive care setting, use of carperitide in infusion-and-output control after preeclampsia and related severe diseases was associated with improved kidney protection, shortened duration of intensive care and hospitalization with fewer side effects. In difficulty of hydration control after preeclampsia, carperitide may be a useful medicine for intensive maternal care. Disclosures A. Shigemitsu: None. J. Akasaka: None. H. Shigetomi: None. T. Tsunemi: None. N. Koike: None. K. Iwai: None. K. Naruse: None. H. Kobayashi: None.
Published Version
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