Antihypertensive Drug Therapy for Hypertensive Disorders in Pregnancy

Hypertension in pregnancy is associated with increased maternal and fetal mortality and morbidity. About 8 % of all pregnancies are complicated with hypertensive disorders. There is concordance that severe hypertension should be treated without delay to reduce maternal risks of acute cerebrovascular complications. Intravenous labetalol and oral nifedipine are as effective as intravenous hydralazine in control of severe hypertension, with less adverse effects. Still, there is no consensus as to whether mild-to-moderate hypertension in pregnancy should be treated, considering that there are no definitive conclusions which can be made about the relative maternal or perinatal benefits/risks of antihypertensive treatment. Considering their safe usage during pregnancy, methyldopa, labetalol and nifedipine are commonly used blood-pressure lowering drugs for pregnant women with hypertension. The cardio-selective βblocker atenolol should be avoided in pregnancy, because it has been associated with lower birth weights and fetal growth impairment. ACE inhibitors and angiotensin receptor blockers are contraindicated in pregnancy. Acta Medica Medianae 2008;47(3):65-72.