| HOW TO MANAGE HYPERTENSION IN PREGNANCY EFFECTIVELY. | |
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MedLine Citation:
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PMID: 21545480 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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The hypertensive disorders of pregnancy (HDP) are a leading cause of maternal mortality and morbidity in both well and under-resourced settings. Maternal, fetal, and neonatal complications of the HDP are concentrated among, but not limited to, women with pre-eclampsia Pre-eclampsia is a systemic disorder of endothelial cell dysfunction and as such, blood pressure (BP) treatment is but one aspect of its management. The most appropriate BP threshold and goal of antihypertensive treatment are controversial. Variation between international guidelines has more to do with differences in opinion rather than differences in published data. For women with severe hypertension [defined as a sustained systolic BP (sBP) of ≥160mmHg and/or a diastolic BP (dBP) of ≥110mmHg], there is consensus that antihypertensive therapy should be given to lower the maternal risk of central nervous system complications. The bulk of the evidence relates to parenteral hydralazine and labetalol, or to oral calcium channel blockers such as nifedipine capsules. There is, however, no consensus regarding management of non-severe hypertension (defined as a sBP of 140-159mmHg or a dBP of 90-109mmHg), because the relevant randomised trials have been underpowered to define the maternal and perinatal benefits and risks. Although antihypertensive therapy may decrease the occurrence of BP values of 160-170/100-110mmHg, therapy may also impair fetal growth. The potential benefits and risks do not seem to be associated with any particular drug or drug class. Oral labetalol and methyldopa are used most commonly, but many different beta-blockers and calcium channel blockers have been studied in clinical trials. |
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Authors:
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Laura A Magee; Baha Sibai; Tom Easterling; Steve Walkinshaw; Edgardo Abalos; Peter von Dadelszen; |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-5-4 |
Journal Detail:
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Title: British journal of clinical pharmacology Volume: - ISSN: 1365-2125 ISO Abbreviation: - Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-5-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7503323 Medline TA: Br J Clin Pharmacol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society. |
Affiliation:
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BC Women's Hospital and Heath Centre and the University of British Columbia 4500 Oak Street, Room D213 Vancouver, BC V6H 3N1 CANADA Tel: 604-875-2960 (sec) Fax: 604-875-2961 E-mail: LMagee@cw.bc.ca Professor and Chairman Department of Obstetrics and Gynecology University of Cincinnati College of Medicine 231 Albert Sabin Way, Cincinnati, OH 45267-0526 USA Tel: 413-558-8449 E-mail: baha.sibai@uc.edu Professor of Obstetrics and Gynecology University of Washington Box 356460, Seattle, WA 98195-6460 Tel: 206-543-1521 E-mail: easter@u.washington.edu Consultant in Maternal-Fetal Medicine Fetal Centre, Liverpool Women's NHS Foundation Trust Crown Street Liverpool L8 7SS UK Tel: 0151 722 5717 Fax: 0151 604 7206 E-mail:steve.walkinshaw@lwh.nhs.net Centro Rosarino De Estudios Perinatales Perinatales (CREP) Pueyrredon 985 2000 Rosario ARGENTINA Tel: +54 341 447 2625 Fax: +54 341 448 3887 E-mail: edgardoabalos@crep.com.ar BC Women's Hospital and Health Centre and the University of British Columbia 4500 Oak Street, Room 2H30 Vancouver, BC V6H 3N1 Tel: 604-875-3054 Fax: 604-875-2725 E-mail: pvd@cw.bc.ca. |
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