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Thiazides in pregnancy

Abstract

Pre-eclampsia is a common complication of late pregnancy and may endanger the life of the mother or her child. The cause is unknown and treatment is aimed at correcting the manifestations of the disease empirically. The signs are hypertension, oedema and proteinuria, and one of these, the oedema, can often be reduced by a thiazide diuretic. In some studies1–3 but not in others4–6 thiazides have also been reported to lower the blood pressure. Proteinuria persists and may worsen7 and the perinatal mortality is not improved8 with thiazide therapy. The placental damage associated with pre-eclampsia and its effects on the foetus are apparently not reversed when the oedema and hypertension are reduced.

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