Low‐dose dopamine for women with severe pre‐eclampsia

Background Hypertensive disorders during pregnancy are important causes of maternal mortality and morbidity worldwide. The long‐term outcome of surviving mothers will depend largely on whether intracranial haemorrhage or renal failure developed. Low‐dose dopamine is used for the prevention and treatment of acute renal failure, but its role in the management of pregnant women with severe pre‐eclampsia is unclear. Objectives To assess the effects of low‐dose dopamine used for oliguria in severe pre‐eclampsia on mothers and their children. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (May 2009). Selection criteria Randomised trials comparing low‐dose dopamine (dosages not higher than 5 microgram/kg/minute) with either placebo or no dopamine in women with severe pre‐eclampsia and acute renal failure, or who are considered to be at risk of acute renal failure. Data collection and analysis The two review authors assessed trial quality and data independently. Main results Only one randomised placebo controlled trial of six hours' duration, including 40 postpartum women, was found. This study showed a significant increase in urinary output over six hours in women receiving dopamine. It is unclear if this was of any benefit to the women. Authors' conclusions It is unclear whether low‐dose dopamine therapy for pre‐eclamptic women with oliguria is worthwhile. It should not be used other than in prospective trials.