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Obstetrics & Gynecology 2004;103:1084-1087
© 2004 by The American College of Obstetricians and Gynecologists
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CASE REPORTS

Ketanserin in Women With Chronic Hypertension and Underlying Thrombophilia

Franyke R. Banga, MD*, Antoinette C. Bolte, MD, PhD*, Gustaaf A. Dekker, MD, PhD{dagger} and Herman P. van Geijn, MD, PhD*

*Department of Obstetrics and Gynecology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands; and {dagger}Women's and Children's Division, Lyell McEwin Hospital, University of Adelaide, Northern Campus, Adelaide, Australia

Address reprint requests to: A. C. Bolte, MD, PhD, Vrije Universiteit Medical Center, Postbox 7057, 1007 MB, Amsterdam, The Netherlands; e-mail: ac.bolte{at}vumc.nl.

BACKGROUND: Pregnant women with chronic hypertension and thrombophilia have an increased risk for preeclampsia and/or intrauterine growth restriction (IUGR). Ketanserin lowers blood pressure and inhibits serotonin-induced platelet aggregation.

CASES: A 38-year-old woman with chronic hypertension had a first pregnancy with severe hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome. A second pregnancy with prophylactic oral ketanserin and low-dose aspirin was uneventful. The third pregnancy without oral ketanserin was again complicated by severe superimposed preeclampsia and IUGR. During this pregnancy a prothrombin mutation was found. A 37-year-old woman with chronic hypertension developed severe early-onset superimposed preeclampsia in her first pregnancy. In the 3 consecutive pregnancies, she was treated with low-molecular-weight heparin because of a factor XII deficiency. Only the pregnancy with the use of prophylactic oral ketanserin was uncomplicated.

CONCLUSION: Clinical trials are warranted to analyze the role of oral ketanserin in preventing preeclampsia and IUGR.






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