HYPITAT

Question 1

HYPITAT: IOL vs expectant monitoring for gestational HT or mild PET after 36/40

Answer 1

Multicentre RCT
N 756 
40 centres
Lancet 2009
Koopmans et al

Inclusion
Singleton 36+0-41+0 with gest HT or mild PET - randomised into:
- IOL
- Expectant (IOL if BP 170/110, HELLP, PPROM, MSL, fetal distress or >41/40)

Question 2

HYPITAT: IOL vs expectant monitoring for gestational HT or mild PET after 36/40

Answer 2

Exclusion:

• Severe gest HT/PET
• Chronic HT on meds
• DM/GDM
• Renal/heart disease
• Previous LSCS
• HELLP, oliguria, APO
• HIV (+)
• Fetal abN/IUGR

Question 3

Outcomes HYPITAT: IOL vs expectant monitoring for gestational HT or mild PET after 36/40

Answer 3

Primary: -
Composite poor maternal outcome [31% vs 44%; RR 0.71 with IOL, NNT 8]
- Mortality
- Morbidity (eclampsia, PE, HELLP, abruption)
- Progress to severe disease
- PPH > 1000mL [no diff]

Secondary:

• MOD [LSCS with IOL but not sig]
• NN morbidity/mortality [no diff]