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An analysis is presented of the obstetric histories of 50 women with acute porphyria, comprising 39 with acute intermittent porphyria, 3 with variegate porphyria and 8 with hereditary coproporphyria. Fifty-four per cent of the women with acute intermittent porphyria had an acute attack of porphyria in pregnancy and/or the puerperium. Only one maternal death was recorded. One patient with variegate porphyria and two with hereditary coproporphyria had an attack related to pregnancy. The total fetal wastage was 13 per cent. The babies born to mothers with acute intermittent porphyria, who experienced an acute attack during pregnancy, were smaller than those in which no such attack occurred (P

I The disposition and effect of orally administered prazosin have been studied in eight women with hypertension which was uncontrolled by /8-adrenoceptor blockade during the last trimester of pregnancy. Results were compared with healthy men of similar age. 2 The median time to peak concentration was 165 min during pregnancy and 120 min in the men (P < 0.04). Area under the concentration vs time curve was 3914 ng 1-' min in pregnancy and 2439 ng l-I min in the men (P < 0.06). Mean elimination half-life was 171 min in the pregnant women and 130 min in the men (P < 0.01). 3 Blood pressure was lowered by prazosin in both supine and standing positions. Blood pressure control remained satisfactory in six of the eight women and the median prolongation of pregnancy was 22 days. Neonatal outcome was satisfactory and all babies are developing normally. 4 We conclude that prazosin is more slowly, but apparently more completely, absorbed during pregnancy and that its half-life is slightly prolonged. Prazosin appears to be both effective and safe when used during the last trimester to control blood pressure.

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Atenolol has been studied prospectively in the management of ten patients with essential hypertension during pregnancy. Median supine BP fell significantly from 156/98 mmHg before treatment to 128/82 mmHg at term. Atenolol did not suppress cardiotocographic signs of foetal distress. Although there was one intrauterine death, the remaining nine babies had a median Apgar score at birth of 9 and a median weight which was 82% of the gestational mean. There were no cases of neonatal bradycardia or respiratory depression and the only case of hypoglycaemia was in a dysmature baby. These findings justify a formal study of B-adrenoceptor blocker therapy in hypertensive diseases of pregnancy.