Methods: Patient characteristics and study design havebeen published (1). In these subanalyses, subjects were con-sidered to be EDLF positive if their plasma inhibited red cellsodium pump mediated Rb uptake. All analyses were redonefor the EDLF positive subgroup by Covance Inc as in the ori-ginal trial. Continuous data were analyzed by ANCOVA. Cat-egorical data were analyzed by Barnard Exact Test.

Results: 45 subjects (23 DIF, 22 placebo) had baseline SPIevaluated. Of these 22% had undetectable SPI. EDLF positivePE women showed greater and more significant reductionsof SPI in response to DIF at each time point (12, 24, 48 hrtreatment) than in the original analysis. Subjects with unde-tectable EDLF showed no significant change in response toDIF or placebo. For CrCl, EDLF positive PE women showedgreater and more significant preservation of CrCl comparedwith original analyses. Subjects absent EDLF showed deteri-oration of CrCl with or without DIF. Among EDLF positive PEwomen DIF treated women had significantly less maternalpulmonary edema (p = 0.035) and significantly less intra-ventricular hemorrhage in their infants (p = 0.015). Therewas the suggestion of reductions in the incidence of othermaternal and neonatal abnormalities.

Conclusion: These data indicate that EDLF positive PEwomen are those that responded to DIF and also raise thepossibility of extended benefits of DIF treatment in thisgroup. Results support further research in this area.

Disclosure of interest: S. Graves Shareholder of: Givenshares of stock in Glenveigh Medical many years ago whichsponsored the clinical trial, Grant/Research Support from:Have had several grants from Glenveigh Medical supportingbasic research in my lab, M. Hopoate-Sitake: None, A. John-ston Consultant for: Director, Clinical Operations for Glen-veigh Medical which sponsored the clinical trial, Employeeof: Director, Clinical Operations for Glenveigh Medical whichsponsored the clinical trial, V. Buckalew: None, G. Lam Grant/Research Support from: Previous research support from Glen-veigh Medical which sponsored the clinical trial, L. Mason:Research nurse overseeing clinical trial; not employed byGlenveigh Medical, D. Adair Shareholder of: Founder of Glen-veigh Medical which sponsored the clinical trial, Employeeof: CEO of Glenveigh Medical which sponsored the trial

doi:10.1016/j.preghy.2012.04.198

PP088. Oral antihypertensive therapy for severe hyper-tension in pregnancyT. Firoz 1,*, L.A. Magee 1, S. Lalani 2, D. Sawchuck 3, B. Payne 3,M. Vidler 3, R. Gordon 3, P. von Dadelszen 3, CLIP (CommunityLevel Interventions for Pre-eclampsia) Working Group(1 Medicine, University of British Columbia, Vancouver,Canada, 2 Faculty of Medicine, University of BritishColumbia, Vancouver, Canada, 3 Obstetrics & Gynaecology,University of British Columbia, Vancouver, Canada)

Introduction: The hypertensive disorders of pregnancy areamong the leading causes of maternal mortality and mor-bidity. The vast majority occurs in low and middle incomecountries. It is widely accepted that women with severe

hypertension are at increased risk of stroke and benefit fromblood pressure (BP) reduction. Although traditionally, paren-teral antihypertensive agents have been studied for treat-ment of severe hypertension in pregnancy, oral agentswould be ideal for use in the community and in under-resourced settings.

Objectives: To review the published evidence for the effec-tiveness of oral antihypertensive therapy for severe hyper-tension in pregnancy.

Methods: The following databases were searched (to May/11) for randomised controlled trials (RCT) of oral antihyper-tensive therapy for severe hypertension in pregnancy: MED-LINE, Cochrane Central Register of Controlled Trials,Cochrane Database of Systematic Reviews, and Database ofAbstracts of Reviews. Inclusion criteria were: severe hyper-tension [an inclusion criterion or average enrollment BP of:systolic BP �160 mmHg and/or diastolic BP �110 mmHg),use of oral or sublingual antihypertensive therapy in at leastone of the treatment arms, and at least one relevant measureof maternal or perinatal outcome within a week of adminis-tration. Data were abstracted independently by two review-ers and discrepancies resolved by consensus. The CochraneRevman 5.1 software was used for statistical analysis accord-ing to standardised methodology.

Results: We identified 14 eligible trials (796 women).Most compared oral/sublingual (SL) nifedipine 5–10 mg(10 trials, 606 women, 8/10 trials specified capsule prepara-tion), with either: intravenous (iv) hydralazine 5–20 mg (6trials, 282 women), oral nifedipine 10 mg PA tablets (1 trial),oral prazosin 1 mg (1 trial), iv labetalol (1 trial), or iv/intra-muscular (im) chlorpromazine 12.5 (1 trial). Three trials(154 women) compared oral methyldopa (250–500 mg ini-tially) with either oral labetalol (100mg), atenolol (50–200 mg) or kentanserin (80–120 mg) (1 trial each). One trial(36 women) compared SL isosorbide 1.25 mg with iv magne-sium sulphate (4 g iv then 1 g/hr). No trials were identifiedthat compared oral labetalol with either parenteral hydral-azine or oral nifedipine.

Nifedipine compared favourably with parenteral hydral-azine with no differences seen in BP control or maternal orperinatal outcomes. Heterogeneity between trial resultswas seen within the oral/SL nifedipine vs. iv hydralazinesubgroup in which one trial evaluated treatment successand side effects over 20 min, and found that nifedipinewas associated with relatively lower success and fewer sideeffects. The incidence of maternal hypotension in the nifed-ipine capsule arms of these trials was low (1/102, 3 trials),but hypotension was common in both arms of a trial ofnifedipine 10 mg capsule vs. 10 mg PA tablet trial (i.e., 11/31 vs. 3/33, risk difference 26%, 95% CI7% to 46%).

Conclusion: Given the available RCT data on which to baseoral antihypertensive treatment of severe hypertension inpregnancy, the choice of antihypertensive agent may needto be driven by the availability of the drug, setting in whichit is to be administered, and by whom. For facility use, theevidence supports oral nifedipine capsules.

Disclosure of interest: None declared

doi:10.1016/j.preghy.2012.04.199

288 Abstracts / Pregnancy Hypertension: An International Journal of Women’s Cardiovascular Health 2 (2012) 240–339