Pregnancy tips Hypertension Treatments In Pregnancy

If you've been diagnosed with hypertension either before or during pregnancy, this article may be of interest. Of course, you want to be extra careful with taking medications and there is an explanation of the recommended drugs and possible alternatives. Read more:

www.medscape.com

From the article:

ethyldopa - A Drug of First Choice

Methyldopa is a drug of first choice for control of mild to moderate hypertension in pregnancy and is the most widely prescribed antihypertensive for this indication in several countries, including the US and the UK.[1,2] The wide use of this drug in pregnancy reflects the fact that it has the best documented maternal and fetal safety record, including favourable long term (4.5 to 7.5 year) paediatric follow-up data.[1] During long term use in pregnancy, methyldopa does not alter maternal cardiac output or blood flow to the uterus or kidneys,[1,2] and for all these reasons is generally considered the agent of choice for chronic blood pressure control in pregnancy.[1]
Labetalol -- A Reasonable Alternative

The combined and ß-adrenoceptor blocker labetalol is a peripheral vasodilator which has been shown to be effective in pre-eclamptic and non-proteinuric hypertension in pregnancy.[1] Available data suggest that the antihypertensive effect is not associated with compromised renal or uterine blood flow.[1] In a randomised comparative trial of 263 pregnant women with mild to moderate hypertension, treatment with either labetalol or methyldopa achieved significantly lower maternal blood pressures throughout gestation compared with no medication, and there were no differences among the 3 groups with respect to various clinical outcomes (e.g. gestational age at delivery, birthweight, fetal growth retardation).[7] However, because the safety record of labetalol in pregnancy is not as well established as that of methyldopa, labetalol should probably be considered a second-line agent for pregnant women with chronic hypertension requiring long term drug therapy.[1]
ß-Blockers Useful in Late Pregnancy...

While earlier studies suggested that administration of ß-blockers (particularly those without intrinsic sympathomimetic activity[8]) during pregnancy might increase the chance of intrauterine growth retardation, recent studies have been more reassuring on this point.[1] Nevertheless, the available data are insufficient to rule out unrecognised adverse effects of early and prolonged use of ß-blockers in pregnancy. When used for short periods (<6 weeks) during the third trimester, ß-blockers are effective and well tolerated provided there are no signs of intrauterine growth impairment.[1]
...But Avoid Atenolol

Use of the cardioselective ß-blocker atenolol early in pregnancy in women with chronic hypertension has been shown to result in significantly lower birthweights compared with placebo and other antihypertensive agents.[9,10] The results of these and other studies indicate that treatment with atenolol is associated with fetal growth impairment and that this effect is related to duration of therapy.[9-11] Thus, atenolol should be avoided in early pregnancy and used only with caution in later pregnancy;[1] some advise avoidance of atenolol altogether in pregnancy.[2]