Document Detail


Drugs used in hypertensive diseases in pregnancy.
MedLine Citation:
PMID:  15017338     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: This review will summarize results derived from the most recent publications on the use of drugs in women with hypertensive diseases in pregnancy. RECENT FINDINGS: There is consensus that severe hypertension should be treated without delay to reduce maternal risks of acute cerebrovascular complications. There is no consensus that antihypertensive drugs improve maternal or fetal outcome in mild to moderate hypertension. Evidence exists that antihypertensive drugs may halve the risk of severe hypertension in pregnancy. No proof exists that antihypertensive drugs reduce perinatal mortality or development of preeclampsia, and such drugs have not been associated with improved fetal growth. Clinical trials indicate non-consistent data concerning antihypertensive treatment on antenatal rate of hospitalization, proteinuria at delivery and neonatal respiratory distress syndrome. Hydralazine has for many years been regarded as the first drug of choice for treatment of severe hypertension in pregnancy. Recent findings indicate that the calcium antagonist nifedipine might be a better alternative. Angiotensin converting enzyme inhibitors and angiotensin II receptor antagonists should be discontinued due to fetotoxicity. The beta1-selective adrenoceptor blocker atenolol in the first trimester is associated with low birth weight. SUMMARY: Large randomized controlled trials are urgently needed to determine whether antihypertensive therapy in pregnancy results in greater benefit than risks for mother and fetus.
Authors:
Sven Montán
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in obstetrics & gynecology     Volume:  16     ISSN:  1040-872X     ISO Abbreviation:  Curr. Opin. Obstet. Gynecol.     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-03-12     Completed Date:  2004-10-07     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9007264     Medline TA:  Curr Opin Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  111-5     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynaecology, Lund University, Malmö University Hospital, Malmö, Sweden. sven.montan@skane.se
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / therapeutic use*
Antihypertensive Agents / therapeutic use*
Calcium Channel Blockers / therapeutic use*
Female
Humans
Hypertension / drug therapy*,  physiopathology
Pre-Eclampsia / physiopathology,  prevention & control*
Pregnancy
Pregnancy Complications, Cardiovascular / drug therapy*,  physiopathology
Chemical
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Antihypertensive Agents; 0/Calcium Channel Blockers

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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