human
***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: OBJECTIVE --To compare the effects of uteroplacental circulation of two beta adrenoceptor blockers , atenolol ( cardioselective ) and pindolol ( non-selective with intrinsic sympathomimetic activity ) . DESIGN --Controlled double blind double dummy study . SETTING --Departments of obstetrics and gynaecology in two Swedish university hospitals . SUBJECTS--29 women with pregnancy induced hypertension in the third trimester , 13 r and omised to atenolol and 16 to pindolol .  MAIN OUTCOME MEASURES --Pulsatility index in fetal aorta , umbilical artery , and maternal arcuate artery . Volumetric blood flow in fetal aorta and umbilical vein . RESULTS --Mean arterial blood pressure decreased by 9.0 ( 95 % confidence interval -13.0 to -5.0 ) mm Hg in the atenolol group and by 7.8 ( -11.4 to -4.2 ) mm Hg in the pindolol group . During atenolol treatment the pulsatility index increased significantly from 1.82 ( SD 0.20 ) to 2.07 ( 0.32 ) in the fetal thoracic descending aorta , from 1.44 ( 0.28 ) to 1.79 ( 0.27 ) in the abdominal aorta , and from 0.93 ( 0.17 ) to 1.05 ( 0.19 ) in the umbilical artery ; the volumetric blood flow in the umbilical vein decreased from 106 ( 28.8 ) to 84 ( 22.6 ) ml/min/kg . No such changes were seen after treatment with pindolol . Birth weight was similar in the two groups but placental weight was significantly different ( 529 ( 122 ) g in atenolol group v 653 ( 136 ) g in pindolol group ; p = 0.03 ) . CONCLUSION --The hypotensive effect was similar with both drugs , but only the beta 1 blocker atenolol had significant effects on fetal haemodynamics , although within normal ranges . The implication s of these findings can be only speculative , but negative fetal consequences of beta 1 adrenoceptor blockade can not be excluded OBJECTIVE Our purpose was to study the effects of isradipine , a dihydropyridine calcium channel blocker , on mother and fetus in the treatment of hypertensive disorders of pregnancy . STUDY DESIGN The investigation was performed as a two-group , parallel , double-blind multicenter study of isradipine versus placebo .  Fifty-four women were r and omized to treatment with isradipine slow-release capsules given orally 5 mg twice a day and 57 to a  placebo group . RESULTS Isradipine lowered the maternal mean arterial blood pressure effectively in women with nonproteinuric hypertension but did not do so in women with proteinuria at recruitment or appearing during treatment . Blood flow in the umbilical artery and maternal renal and liver function were not influenced by treatment . Isradipine had few side effects and was well tolerated . CONCLUSION Calcium channel blockade with isradipine is effective for treatment of nonproteinuric hypertension but not in preeclampsia 195 ( 97.5 % ) children born to hypertensive women participating in a trial of methyldopa treatment during pregnancy were followed from birth and were extensively examined at the age of 7 1/2 years . The frequency of problems with health , physical or mental h and icap , sight , hearing , and behaviour was the same in children of treated and untreated women . Sons of the untreated women were heavier and taller than those of treated women , as were their mothers . Among children of women who entered the trial between 16 and 20 weeks ' gestation , sons of untreated women had larger heads than sons of treated women , but there was no difference in mean intelligence quotients . There were no significant differences between the children in the treated and untreated groups in st and ing and supine blood pressures , or fourteen tests of ability .  Methyldopa therefore seems safe to use in pregnancy and is probably preferable to other drugs from the point of view of the neonate and child One hundred and eighty three hypertensive pregnant women were r and omly assigned to antihypertensive treatment with oxprenolol ( 96 women ) or methyldopa ( 87 women ) . Control of hypertension was equivalent in both treatment groups , and in 64 ( 35 % ) cases hydralazine had to be added to the treatment to achieve the therapeutic goal ( diastolic blood pressure below 85 mm Hg ) . Five perinatal deaths occurred , one in the oxprenolol group and four in the methyldopa group . Detailed analysis confirmed a previous report of greater fetal growth in the group treated with oxprenolol ; this trend was present regardless of severity of hypertension and parity . With increasing duration of treatment the differences between the two groups diminished , and there was no difference after 10 weeks of treatment , a finding that may explain some of the reported discrepancies among therapeutic studies . As hypertension in pregnancy may pursue an accelerated course , necessitating urgent delivery , and there is no satisfactory method of predicting the duration of treatment in individual patients fetal benefit is most likely to be achieved by treatment with oxprenolol , provided that there is no maternal contraindication to treatment with beta blockers OBJECTIVE The effects of two antihypertensive drugs , methyldopa and isradipine , on fetal heart rate pattern were analyzed by computerized cardiotocography . STUDY DESIGN The first part of the study was a prospect i ve , r and omized , controlled trial of 19 women with preeclampsia in the third trimester given 2.5 mg of oral slow-release isradipine twice a day or 250 mg of methyldopa three times a day . In a second part of the study 23 women with preeclampsia in the third trimester given 5 mg of oral slow-release isradipine twice a day were compared with 23 matched controls without medication . Main outcome measures were maternal blood pressure and mean baseline fetal heart rate , fetal movements , number of accelerations , periods of high and low baseline variability , and mean baseline heart rate variability . RESULTS Compared with the pretreatment value , the mean arterial blood pressure decreased significantly in all drug treatment groups . Fetal heart rate characteristics were not significantly changed during drug treatment or bed rest . CONCLUSION The various features of the fetal heart rate pattern evaluated by computerized methods were not influenced by treatment with methyldopa or isradipine To test the effects of calcium dobesilate ( Doxium ) in pregnancies complicated with pregnancy-induced hypertension or mild/moderate pre-eclampsia a double-blind , placebo-controlled pilot study was carried out . Primigravida patients ( gestational age ≤34 weeks ) daily took 2 g Doxium or placebo until delivery . Twelve patients received placebo for 53 days , and 11 patients took the drug for 57 days on average . At the start of the study 2 patients in the placebo group ( PG ) and 8 in the Doxium group ( DG ) had pre-eclampsia . The mean arterial pressure ( mean ± SD ) significantly decreased from 118 ± 7 to 99 ± 9 mm Hg in the DG ( p = 0.003 ) , while in the PG it had slightly increased by the end of the study . Proteinuria was higher in the DG at the start but not at the end ; however , significant changes of this parameter were detected in neither of the groups throughout the study . Fibronectin decreased significantly in both groups but it was more pronounced in the DG ( 23.8 vs. 9.4 % ) . Changes of platelet count , plasma and blood viscosity , and erythrocyte deformability were favourable in the DG but in the PG these parameters had deteriorated although the alterations were not significant . No marked differences were found between the two groups regarding fetal well-being , courses of deliveries , and the neonatal period . Neither maternal nor fetal/neonatal side effects were noticed . It seems that Doxium favourably influences the blood pressure and consequently decreases the requirement for medication and hospitalisation in cases of mild to moderate midtrimester hypertension In a prospect i ve study , women who were hypertensive before the 28th wk of gestation were r and omly allocated into two groups : those who received specific hypotensive therapy ( Ht )  and those who did not ( Hu ) . The outcome was compared with a r and om sample of the hospital population ( S ) ascertained after delivery . In both hypertensive groups there was a higher incidence of clinical signs of possible fetal distress and instrumental delivery . Although there was no difference between the groups in the distribution of birthweight above and below the mean for gestational age , the treated hypertensive group had an excess of infants with relatively smaller head circumferences for their gestational age compared with both the untreated hypertensive group and the hospital sample . Tube-feeding was also more frequent in the treated hypertensive group . In the untreated hypertensive group there were more infants whose neurological status was categorized as question able or abnormal in the neonatal period , compared with the sample . The different problems encountered by infants in the two hypertensive groups emphasized the need for further study of these babies . Their development during the first year of life will be examined in a subsequent paper OBJECTIVE The main purpose of our study was to analyse efficacy and safety of acebutolol ( Sectral ) in the treatment of hypertension in pregnancy . DESIGN Cohort clinical study comparing efficacy and safety of acebutolol with other antihypertensive drugs by 77 patients and their 81 newborns . The number of 48 patients were treated by acebutolol .  SETTING Internal Medicine and Clinical Pharmacology Department , Regional Hospital , Nitra and The Faculty of Health Service and Social Work , University of Trnava ; Department of Gynaecology and Obstetrics , Regional Hospital Nitra and The Faculty of Health Service and Social Work , University of Trnava ; Institute of Pharmacology , The Faculty of Medicine , Komenského University , Bratislava ; Environment , a.s . Nitra . METHODS During the period of 6 years our patients were divided into subgroups according to the type of hypertension in pregnancy and the severity of the illness which was the basis for used antihypertensive drugs . One of the topics of the study was to provide monitoring of adverse events by mother and possible drug influence on their new-born has been evaluated by investigating the week of birth , weight and length of the new-born and evaluating of Apgar score . RESULTS In the subgroup of 48 women treated by acebutolol we have confirmed the efficacy and safety of this antihypertensive drug without any clinical ly significant effect on the quality of life of their new-born and evaluating of Apgar score . CONCLUSION With regard to the results of our clinical study we can consider acebutolol to be effective and safe antihypertensive drug in the treatment of hypertension in pregnancy OBJECTIVE --To determine the effect of atenolol on the outcome of pregnancy in women with essential hypertension . DESIGN -- Prospect i ve , r and omised , double blind , placebo controlled study . SETTING --Hospital clinic . PATIENTS --33 Women with mild essential hypertension ( systolic blood pressure 140 - 170 mm Hg or diastolic pressure 90 - 110 mm Hg on two occasions at least 24 hours apart ) consecutively referred to two obstetric medical clinics . Four patients in the  placebo group were withdrawn from the study : control of blood pressure was inadequate in two , one developed breathlessness , and one changed her mind about participating . The mean gestation in the 29 remaining women on entry to the study was 15.9 weeks . MAIN OUTCOME MEASURES --Blood pressure and birth weight . INTERVENTION--14 Women received placebo . 15 Women received atenolol 50 mg daily initially , increasing until either the blood pressure was less than 140/90 mm Hg or a dose of 200 micrograms daily was reached . RESULTS --The mean blood pressure on entry was 148/86 mm Hg in the group given atenolol and 144/86 mm Hg in the group given placebo . During treatment the mean diastolic pressure was significantly reduced by atenolol compared with placebo ( to 74 v 81 mm Hg ; difference in means ( 95 % confidence interval ) 7.0 ( 2.9 to 10.0 ) mm Hg ) but the effect on systolic pressure was marginal ( 132 v 136 mm Hg ; 4.0 ( -1.4 to 8.6 ) mm Hg ) . Babies in the atenolol group had a significantly lower birth weight than those in the placebo group ( 2620 g v 3530 g ; 910 ( 440 to 1380)g ) . CONCLUSION --Atenolol given from the end of the first trimester in patients with mild hypertension is associated with intrauterine growth retardation . When taken in conjunction with the results of a previous study in which methyldopa was given these findings indicate that benefit is unlikely to result from treating mild essential hypertension in pregnancy A placebo-controlled trial was used to assess the antihypertensive efficacy of indoramin in the management of  pregnancy hypertension . Sixty patients were recruited into the study and only 17 attained satisfactory blood pressure control .  In the doses of drugs administered indoramin was not shown to be more effective than alpha-methyldopa OBJECTIVE To determine the haemostatic status in preeclampsia and to investigate the effects of short-term use of anti-hypertensive 
    Output:
    
agent
REVIEW ER 'S CONCLUSIONS It remains unclear whether antihypertensive drug therapy for mild-moderate hypertension during pregnancy is worthwhile
***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: OBJECTIVE --To compare the effects of uteroplacental circulation of two beta adrenoceptor blockers , atenolol ( cardioselective ) and pindolol ( non-selective with intrinsic sympathomimetic activity ) . DESIGN --Controlled double blind double dummy study . SETTING --Departments of obstetrics and gynaecology in two Swedish university hospitals . SUBJECTS--29 women with pregnancy induced hypertension in the third trimester , 13 r and omised to atenolol and 16 to pindolol .  MAIN OUTCOME MEASURES --Pulsatility index in fetal aorta , umbilical artery , and maternal arcuate artery . Volumetric blood flow in fetal aorta and umbilical vein . RESULTS --Mean arterial blood pressure decreased by 9.0 ( 95 % confidence interval -13.0 to -5.0 ) mm Hg in the atenolol group and by 7.8 ( -11.4 to -4.2 ) mm Hg in the pindolol group . During atenolol treatment the pulsatility index increased significantly from 1.82 ( SD 0.20 ) to 2.07 ( 0.32 ) in the fetal thoracic descending aorta , from 1.44 ( 0.28 ) to 1.79 ( 0.27 ) in the abdominal aorta , and from 0.93 ( 0.17 ) to 1.05 ( 0.19 ) in the umbilical artery ; the volumetric blood flow in the umbilical vein decreased from 106 ( 28.8 ) to 84 ( 22.6 ) ml/min/kg . No such changes were seen after treatment with pindolol . Birth weight was similar in the two groups but placental weight was significantly different ( 529 ( 122 ) g in atenolol group v 653 ( 136 ) g in pindolol group ; p = 0.03 ) . CONCLUSION --The hypotensive effect was similar with both drugs , but only the beta 1 blocker atenolol had significant effects on fetal haemodynamics , although within normal ranges . The implication s of these findings can be only speculative , but negative fetal consequences of beta 1 adrenoceptor blockade can not be excluded OBJECTIVE Our purpose was to study the effects of isradipine , a dihydropyridine calcium channel blocker , on mother and fetus in the treatment of hypertensive disorders of pregnancy . STUDY DESIGN The investigation was performed as a two-group , parallel , double-blind multicenter study of isradipine versus placebo .  Fifty-four women were r and omized to treatment with isradipine slow-release capsules given orally 5 mg twice a day and 57 to a  placebo group . RESULTS Isradipine lowered the maternal mean arterial blood pressure effectively in women with nonproteinuric hypertension but did not do so in women with proteinuria at recruitment or appearing during treatment . Blood flow in the umbilical artery and maternal renal and liver function were not influenced by treatment . Isradipine had few side effects and was well tolerated . CONCLUSION Calcium channel blockade with isradipine is effective for treatment of nonproteinuric hypertension but not in preeclampsia 195 ( 97.5 % ) children born to hypertensive women participating in a trial of methyldopa treatment during pregnancy were followed from birth and were extensively examined at the age of 7 1/2 years . The frequency of problems with health , physical or mental h and icap , sight , hearing , and behaviour was the same in children of treated and untreated women . Sons of the untreated women were heavier and taller than those of treated women , as were their mothers . Among children of women who entered the trial between 16 and 20 weeks ' gestation , sons of untreated women had larger heads than sons of treated women , but there was no difference in mean intelligence quotients . There were no significant differences between the children in the treated and untreated groups in st and ing and supine blood pressures , or fourteen tests of ability .  Methyldopa therefore seems safe to use in pregnancy and is probably preferable to other drugs from the point of view of the neonate and child One hundred and eighty three hypertensive pregnant women were r and omly assigned to antihypertensive treatment with oxprenolol ( 96 women ) or methyldopa ( 87 women ) . Control of hypertension was equivalent in both treatment groups , and in 64 ( 35 % ) cases hydralazine had to be added to the treatment to achieve the therapeutic goal ( diastolic blood pressure below 85 mm Hg ) . Five perinatal deaths occurred , one in the oxprenolol group and four in the methyldopa group . Detailed analysis confirmed a previous report of greater fetal growth in the group treated with oxprenolol ; this trend was present regardless of severity of hypertension and parity . With increasing duration of treatment the differences between the two groups diminished , and there was no difference after 10 weeks of treatment , a finding that may explain some of the reported discrepancies among therapeutic studies . As hypertension in pregnancy may pursue an accelerated course , necessitating urgent delivery , and there is no satisfactory method of predicting the duration of treatment in individual patients fetal benefit is most likely to be achieved by treatment with oxprenolol , provided that there is no maternal contraindication to treatment with beta blockers OBJECTIVE The effects of two antihypertensive drugs , methyldopa and isradipine , on fetal heart rate pattern were analyzed by computerized cardiotocography . STUDY DESIGN The first part of the study was a prospect i ve , r and omized , controlled trial of 19 women with preeclampsia in the third trimester given 2.5 mg of oral slow-release isradipine twice a day or 250 mg of methyldopa three times a day . In a second part of the study 23 women with preeclampsia in the third trimester given 5 mg of oral slow-release isradipine twice a day were compared with 23 matched controls without medication . Main outcome measures were maternal blood pressure and mean baseline fetal heart rate , fetal movements , number of accelerations , periods of high and low baseline variability , and mean baseline heart rate variability . RESULTS Compared with the pretreatment value , the mean arterial blood pressure decreased significantly in all drug treatment groups . Fetal heart rate characteristics were not significantly changed during drug treatment or bed rest . CONCLUSION The various features of the fetal heart rate pattern evaluated by computerized methods were not influenced by treatment with methyldopa or isradipine To test the effects of calcium dobesilate ( Doxium ) in pregnancies complicated with pregnancy-induced hypertension or mild/moderate pre-eclampsia a double-blind , placebo-controlled pilot study was carried out . Primigravida patients ( gestational age ≤34 weeks ) daily took 2 g Doxium or placebo until delivery . Twelve patients received placebo for 53 days , and 11 patients took the drug for 57 days on average . At the start of the study 2 patients in the placebo group ( PG ) and 8 in the Doxium group ( DG ) had pre-eclampsia . The mean arterial pressure ( mean ± SD ) significantly decreased from 118 ± 7 to 99 ± 9 mm Hg in the DG ( p = 0.003 ) , while in the PG it had slightly increased by the end of the study . Proteinuria was higher in the DG at the start but not at the end ; however , significant changes of this parameter were detected in neither of the groups throughout the study . Fibronectin decreased significantly in both groups but it was more pronounced in the DG ( 23.8 vs. 9.4 % ) . Changes of platelet count , plasma and blood viscosity , and erythrocyte deformability were favourable in the DG but in the PG these parameters had deteriorated although the alterations were not significant . No marked differences were found between the two groups regarding fetal well-being , courses of deliveries , and the neonatal period . Neither maternal nor fetal/neonatal side effects were noticed . It seems that Doxium favourably influences the blood pressure and consequently decreases the requirement for medication and hospitalisation in cases of mild to moderate midtrimester hypertension In a prospect i ve study , women who were hypertensive before the 28th wk of gestation were r and omly allocated into two groups : those who received specific hypotensive therapy ( Ht )  and those who did not ( Hu ) . The outcome was compared with a r and om sample of the hospital population ( S ) ascertained after delivery . In both hypertensive groups there was a higher incidence of clinical signs of possible fetal distress and instrumental delivery . Although there was no difference between the groups in the distribution of birthweight above and below the mean for gestational age , the treated hypertensive group had an excess of infants with relatively smaller head circumferences for their gestational age compared with both the untreated hypertensive group and the hospital sample . Tube-feeding was also more frequent in the treated hypertensive group . In the untreated hypertensive group there were more infants whose neurological status was categorized as question able or abnormal in the neonatal period , compared with the sample . The different problems encountered by infants in the two hypertensive groups emphasized the need for further study of these babies . Their development during the first year of life will be examined in a subsequent paper OBJECTIVE The main purpose of our study was to analyse efficacy and safety of acebutolol ( Sectral ) in the treatment of hypertension in pregnancy . DESIGN Cohort clinical study comparing efficacy and safety of acebutolol with other antihypertensive drugs by 77 patients and their 81 newborns . The number of 48 patients were treated by acebutolol .  SETTING Internal Medicine and Clinical Pharmacology Department , Regional Hospital , Nitra and The Faculty of Health Service and Social Work , University of Trnava ; Department of Gynaecology and Obstetrics , Regional Hospital Nitra and The Faculty of Health Service and Social Work , University of Trnava ; Institute of Pharmacology , The Faculty of Medicine , Komenského University , Bratislava ; Environment , a.s . Nitra . METHODS During the period of 6 years our patients were divided into subgroups according to the type of hypertension in pregnancy and the severity of the illness which was the basis for used antihypertensive drugs . One of the topics of the study was to provide monitoring of adverse events by mother and possible drug influence on their new-born has been evaluated by investigating the week of birth , weight and length of the new-born and evaluating of Apgar score . RESULTS In the subgroup of 48 women treated by acebutolol we have confirmed the efficacy and safety of this antihypertensive drug without any clinical ly significant effect on the quality of life of their new-born and evaluating of Apgar score . CONCLUSION With regard to the results of our clinical study we can consider acebutolol to be effective and safe antihypertensive drug in the treatment of hypertension in pregnancy OBJECTIVE --To determine the effect of atenolol on the outcome of pregnancy in women with essential hypertension . DESIGN -- Prospect i ve , r and omised , double blind , placebo controlled study . SETTING --Hospital clinic . PATIENTS --33 Women with mild essential hypertension ( systolic blood pressure 140 - 170 mm Hg or diastolic pressure 90 - 110 mm Hg on two occasions at least 24 hours apart ) consecutively referred to two obstetric medical clinics . Four patients in the  placebo group were withdrawn from the study : control of blood pressure was inadequate in two , one developed breathlessness , and one changed her mind about participating . The mean gestation in the 29 remaining women on entry to the study was 15.9 weeks . MAIN OUTCOME MEASURES --Blood pressure and birth weight . INTERVENTION--14 Women received placebo . 15 Women received atenolol 50 mg daily initially , increasing until either the blood pressure was less than 140/90 mm Hg or a dose of 200 micrograms daily was reached . RESULTS --The mean blood pressure on entry was 148/86 mm Hg in the group given atenolol and 144/86 mm Hg in the group given placebo . During treatment the mean diastolic pressure was significantly reduced by atenolol compared with placebo ( to 74 v 81 mm Hg ; difference in means ( 95 % confidence interval ) 7.0 ( 2.9 to 10.0 ) mm Hg ) but the effect on systolic pressure was marginal ( 132 v 136 mm Hg ; 4.0 ( -1.4 to 8.6 ) mm Hg ) . Babies in the atenolol group had a significantly lower birth weight than those in the placebo group ( 2620 g v 3530 g ; 910 ( 440 to 1380)g ) . CONCLUSION --Atenolol given from the end of the first trimester in patients with mild hypertension is associated with intrauterine growth retardation . When taken in conjunction with the results of a previous study in which methyldopa was given these findings indicate that benefit is unlikely to result from treating mild essential hypertension in pregnancy A placebo-controlled trial was used to assess the antihypertensive efficacy of indoramin in the management of  pregnancy hypertension . Sixty patients were recruited into the study and only 17 attained satisfactory blood pressure control .  In the doses of drugs administered indoramin was not shown to be more effective than alpha-methyldopa OBJECTIVE To determine the haemostatic status in preeclampsia and to investigate the effects of short-term use of anti-hypertensive 
    Output:
    