3-4FUROSEMIDE USE AS POSTPARTUM MANAGEMENT IN WOMEN WITH HYPERTENSIVE DISORDER OF PREGNANCY: A SYSTEMATIC REVIEW

Introduction: Hypertensive disorders of pregnancy affect 10 % of pregnancy worldwide. It is also complicated maternal mortality and morbidity. Hypertensive disorders may persist after delivery in the puerperal period up to 12 weeks postpartum. The physiologic changes in pregnancy revert to normal in the postpartum period. Including the return of fluid from interstitial and extravascular compartments into intravascular. The use of diuretics is more fitting in the postpartum period and as an additional anti-hypertensive agent. Methods: We formulated a specific search strategy and used the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). PubMed, Cochrane, Scopus, Science Direct, and Ebscohost are used as the literature Database. The criteria of the included studies are as follows: human study, randomized controlled trial; relevant patient characteristic; outcome assessment. Two independent authors assessed the quality of the study. This systematic review used the Cochrane Risk of Bias Tool 2.0. Results: Database searching provides a total of 58 studies. A total of 29 studies are duplicates. Six studies are included in the qualitative synthesis. One study does not show the results of the trial. A total of five studies are used. All studies are randomized controlled trials. One study reveals that there was a significant difference in systolic blood pressure, diastolic blood pressure, and mean arterial pressure between the treatment group and the control group. Another study reveals that the use of furosemide reduces the use of another antihypertensive therapy on the hospital and when discharged. Three studies show the insignificant result in reducing anti-hypertensive agents and blood pressure. Conclusion: Furosemide use as an anti-hypertensive agent on the postpartum setting is still unclear. Furosemide therapy may be useful in reducing the risk of complications in a patient with severe preeclampsia on postpartum settings such as eclampsia and pulmonary edema. Furosemide may reduce the amounts of anti-hypertensive agents used. Length of stay is the hospital may not be affected by the use of furosemide. The additional high-quality study should be conducted to elucidate furosemide use as a puerperal anti-hypertensive agent.