An open trial comparing isradipine with hydralazine and methyl dopa in the treatment of patients with severe pre-eclampsia.

Placental blood flow is decreased in pre-eclampsia and is worsened by decreasing blood pressure. Hydralazine, which causes vasodilatation, does not affect placental bed vessels. Calcium channel blockers (like isradipine) are vasodilators that do affect placental bed vessels and should improve blood flow even while decreasing blood pressure. The aim of the study was to determine if isradipine (parenteral and oral) was better than parenteral hydralazine and oral methyl dopa in severe pre-eclampsia in achieving better control of blood pressure. The study was a prospective randomised trial performed at The University Hospital of the West Indies. The sample consisted of 39 women with severe pre-eclampsia. Variables examined consisted of blood pressure before and after treatment, the increment in gestational age at delivery related to treatment, fetal Apgar score and birth weight. There were no significant differences in any of these variables between the two groups. Isradipine was as effective as hydralazine in reducing maternal blood pressure and in prolonging pregnancy.