Severe preeclampsia can be associated with persistent or worsening high blood pressure after delivery. This randomized, double-blind, placebo-controlled trial will evaluate the efficacy of oral furosemide as an add-on treatment for postpartum blood pressure control in women with severe preeclampsia.
The study will be conducted in the Department of Obstetrics and Gynaecology, Lady Reading Hospital (MTI), Peshawar. A total of 434 women will be randomized into two groups, with 217 participants in each group. The intervention group will receive oral furosemide 20 mg once daily for 5 days after delivery, while the control group will receive a placebo tablet once daily for 5 days. Both groups will receive standard postpartum antihypertensive management, including monitoring and labetalol when required.
Participants will be followed from delivery through 7 days postpartum. Blood pressure will be monitored daily, including assessment of severe-range hypertension, symptoms, adverse events, and the need for additional antihypertensive medication. The primary assessment of efficacy will be based on achieving blood pressure below 140/90 mmHg on two readings 48 hours apart, without systolic blood pressure reaching 160 mmHg or higher or diastolic blood pressure reaching 110 mmHg or higher, and without requiring an increase in antihypertensive medication through 7 days postpartum.