***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A r and omized double-blind investigation of the early , continuous , prophylactic use of hydrochlorothiazide ( 50 mg daily ) was undertaken with 1,030 obstetrical patients . Twenty-eight percent of the patients were teenagers and 39 % were nulliparas .  Hypokalemia and hyperuricemia were significantly increased in the hydrochlorothiazide group , but the patients were asymptomatic . The total incidence of hypertension was 19.6 % in the hydrochlorothiazide group and 21.8 % in the placebo group . Preeclampsia occurred in 3 % of the former group and in 3.8 % of the latter . Excessive weight gain was evident in 13.9 % of the placebo group as compared to 7.7 % of the hydrochlorothiazide group ( P= 0.002 ) . The average fetal weight and the incidence of prematurity , congenital anomalies , and perinatal mortality were similar in both groups . No complications related to thiazides were encountered in the 1,040 newborns . The data demonstrated that long-term , prophylactic use of hydrochlorothiazide in pregnancy did not alter the incidence of preeclampsia , hypertension , prematurity , congenital anomalies , or perinatal mortality Summary Furosemide 50 mg was administered orally and intravenously to twelve gestotic women for brief periods as a part of a r and omized , multicentre clinical trial comparing the efficacy of bed rest and pharmacological treatment . The pharmacokinetic profile was investigated using a gas-liquid chromatographic technique . The plasma half-life after oral and intravenous administration was 115±37.1 and 71.8±26.3 min and plasma clearance was 153±48 and 152±23 ml/min , respectively ( mean±SD ) . Comparative data from healthy pregnant women can not be obtained for ethical reasons . The results show that gestosis has only a marginal if any effect on the kinetics of furosemide in comparison with published kinetic parameters in healthy volunteers and patients with renal failure . The new-born babies where checked for side effects according to a protocol in use in a larger regional surveillance programme . No clinical side-effects were attributable to furosemide , but the small size of the group does not permit any definitive conclusions about this aspect Over the past 20 years at least 11 r and omised trials of the prevention with diuretics of pre-eclampsia and its sequelae have been undertaken . Nine of these were review ed . Reliable data from the remaining two were not available . The nine review ed had investigated a total of nearly 7000 people . Significant evidence of prevention of " pre-eclampsia " was overwhelming , even when oedema was not included as a diagnostic criterion . But as the definitions of pre-eclampsia that had been used depended heavily on increases in blood pressure this evidence may simply have reflected the well known ability of diuretics to reduce blood pressure . When the data on perinatal death were review ed a little difference was seen in postnatal survival . The incidence of stillbirths was reduced by about one third with treatment , but , perhaps owing to small numbers ( only 37 stillbirths ) , the difference was not significant . Thus these r and omised trials failed to provide reliable evidence of either the presence or the absence of any worthwhile effects of treatment with diuretics on perinatal mortality . The implication s of this for current and future trials of beta blockers and other agents in the prevention of  pre-eclampsia  and its sequelae are that extremely large , ultra simple r and omised trials are needed , of a size sufficient to permit direct assessment of the effects of treatment not on pre-eclampsia but on perinatal mortality itself . This may require the study of tens of thous and s of pregnancies In a series comprising 211 pregnant patients , the prophylactic effect of chlorthalidone on the incidence of gestosis  was studied by means of a single‐blind trial . The study continued from the 16th week of pregnancy until term . No beneficial effects were observed . In addition , the maternal serum potassium and sodium levels were found to be significantly lowered in the diuretic group . This made it necessary to administer potassium perorally to most of this group and to two of them even in the form of infusions . No significant differences in the parameters of the newborn infants were observed . On the other h and , the placentae in the diuretic group were definitely larger than in the control group , a fact which may be suggestive or eventual alterations in the glycogen metabolism A 1200 calorie diet or cyclopenthiazide with potassium was given to two groups of 51 high weight gain primigravidae and baby weight and the incidence of pre‐eclampsia  were compared with those in a matched control group . There was no difference in the development of pre‐eclampsia , but the weight of babies in the control group was higher than in the treated groups . The body fat was reduced in the diet group and the total body water in the diuretic group The use of a diuretic is frequently advocated in pregnancies complicated by excessive weight gain , generalised oedema , hypertension , or overt pre-eclampsia . A wide range of drugs has been tried under such circumstances . One of the newer diuretic agents is Aldactone-A , a spironolactone possessing antagonistic action to aldosterone , and this drug has also been recommended for the resistant types of oedema . Since it was first described in 1957 ( Kagawa et al. , 1957 ) , conflicting reports have been received concerning its effects in normal and pre-eclamptic pregnancies . Although its clinical and pharmacological effects have been studied in the non-pregnant state , much less is known about its place during pregnancy and its effects on the feto-placental unit . Since it possesses a different mechanism of action to other diuretic agents in common use , the administration of Aldactone-A in combination with other diuretic agents may be advantageous and may reduce the incidence of undesirable pharmacological effects . The present study reports the results of a clinical therapeutic trial involving the use of an aldosterone antagonist , Aldactone-A , a st and ard thiazide diuretic agent in current use , methychlothiazide ( Enduron ) , and a combination of these two agents , in pregnancy complicated by hypertension . During the study , the effect of these agents on urinary oestriol excretion was also assessed The purpose of this r and omized , prospect i ve study was to investigate the effects of diuretics on plasma volume findings and perinatal outcome in pregnancies complicated by mild long-term hypertension . Twenty patients were in their first trimester and were receiving diuretics at time of entry to the study : Ten patients were allowed to continue their diuretic medication throughout pregnancy ( diuretic group ) , whereas for the other 10 patients , diuretics were discontinued immediately .  Plasma volume was serially measured throughout pregnancy with the use of the Evans blue dye-dilution technique . Initial plasma volume was similar in the two groups . However , in the diuretic group , subsequent plasma volume findings at various stages of gestation were markedly reduced when compared to respective plasma volume findings in the other group . In addition , plasma volume expansion was minimal in the diuretic group ( mean increase of 18 % ) , whereas it was normal in the other group ( mean increase of 52 % ) . Two patients in the diuretic group and one patient in the other group required other antihypertensive medication . There was no difference in perinatal outcome between the two groups . These results suggest that in hypertensive pregnancies , diuretics prevent normal plasma volume expansion without influencing perinatal outcome Abstract A controlled trial of bendrofluazide and methyldopa in 100 patients with hypertension in pregnancy is reported . In patients developing hypertension before twenty weeks of pregnancy treatment seemed to improve the chances of a successful outcome to the pregnancy . In those developing late hypertension treatment was of no value in the presence of proteinuria . The presence or absence of proteinuria seemed to be of more importance than the level of the diastolic pressure 
    Output:
    
There is insufficient evidence to draw reliable conclusions about the effects of diuretics on prevention of pre-eclampsia and its complications .
However , from this review , no clear benefits have been found from the use of diuretics to prevent  pre-eclampsia .