Just how benign is renal dopamine?:

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 STRATEGY

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (June 2006).

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.

Phentolamine use in a neonate for the prevention of dermal necrosis caused by dopamine: a case report

Skin ischemia, necrosis, and gangrene are uncommon but known complications of dopamine extravasation. In most cases, these complications are associated with the use of high-dosage dopamine infusion. Subcutaneous phentolamine has been used as a therapeutic agent for these complications. However, this is the report of the first neonatal case report in the English literature of prompt reversal of imminent dermal ischemia and necrosis associated with low-dose dopamine infusion using subcutaneous phentolamine.