A Controlled Trial of Hypotensive Agents in Hypertension in Pregnancy

Leather, Hugh; Humphreys, D M; Baker, Patricia; Chadd, M. A.

doi:10.1097/00006254-196904000-00005

Cited by 6 publications

(7 citation statements)

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“…Perinatal mortality has been shown to be lower in mild pregnancy-induced hypertension (PIH). 3 When moderate or severe hypertension occurs with proteinuria, mortality rates are raised and active treatment results in a lower perinatal mortality rate. 3 Management of PIH differs from that of hypertension in non-pregnant individuals in several important ways, with treatment generally being needed for a limited duration and at higher blood pressure (BP) targets in PIH.…”

Section: Introductionmentioning

confidence: 99%

“…3 When moderate or severe hypertension occurs with proteinuria, mortality rates are raised and active treatment results in a lower perinatal mortality rate. 3 Management of PIH differs from that of hypertension in non-pregnant individuals in several important ways, with treatment generally being needed for a limited duration and at higher blood pressure (BP) targets in PIH. Further, treatment of PIH often involves adjustment between competing concerns for maternal health, gestational age of the infant and fetal exposure to antihypertensive drugs.…”

Section: Introductionmentioning

confidence: 99%

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Comparative evaluation of antihypertensive drugs in the management of pregnancy-induced hypertension

Patel

Gadhavi

Gorasia

et al. 2012

Int J Basic Clin Pharmacol

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Background: Pregnancy-induced hypertension is associated with various adverse fetal and maternal outcomes. The use of anti-hypertensive drugs in pregnancy is controversial. We conducted a prospective study to evaluate the comparative effectiveness and safety of nifedipine, methyldopa and labetalol monotherapy in patients with pregnancy-induced hypertension. Methods: A total of 60 pregnant women with blood pressure of 140/90 mm Hg or more with ≥1+ proteinuria between 20 and 38 weeks of gestation were randomly allocated to receive nifedipine (n=20), methyldopa (n=20) or labetalol (n=20). Blood pressure was measured at 0, 6, 24, 48 and 72 h of initiation of antihypertensive drugs. Patients were also followed up for development of adverse drug effects during this period. Results: Antihypertensive treatment with methyldopa was associated with reduction in systolic blood pressure (SBP) by 50 mmHg and diastolic blood pressure (DBP) by 30 mmHg at 72 h. For the same period treatment with nifedipine was associated with reduction in SBP by 54 mmHg and DBP by 30 mmHg. Treatment with labetalol was associated with reduction in SBP by 70 mmHg and DBP by 36 mmHg at 72 h. Conclusions: Labetalol was more effective than methyldopa and nifedipine in controlling blood pressure in patients with pregnancy-induced hypertension while methyldopa and nifedipine are equally effective in controlling blood pressure. [Int J Basic Clin Pharmacol 2012; 1(3.000): 174-177

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of antihypertensive drugs in the management of pregnancy-induced hypertension

Patel

Gadhavi

Gorasia

et al. 2012

Int J Basic Clin Pharmacol

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“…This was largely due to the reluctance of obstetricians to use antihypertensive drugs because of concern about their effects on the fetus. It is now accepted that the control of hypertension with antihypertensive agents is of unequivocal value in terms of fetal survival (Leather et al, 1968;Michael, 1975;Redman et al, 1976). Where hypertension arises in pregnancy and where the fetus is immature, it is possible with treatment to allow the pregnancy to continue by preventing hypertensive sequelae in the mother.…”

Section: Introductionmentioning

confidence: 99%

Use of labetalol in the treatment of severe hypertension during pregnancy.

Ca¹

1979

Brit J Clinical Pharma

101

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1 Labetalol, a hypotensive agent combining a-and fl-adrenoceptor antagonist properties, was used to treat severe hypertensive disease complicating pregnancy. 2 Effective reduction in BP was achieved in all but 3 of the 25 patients treated. Careful monitoring of feto-placental function was undertaken to ensure the maintenance of fetal well-being. Maternal and fetal side-effects were minimal and it was not necessary to discontinue the drug in any patient. 3 Labetalol was estimated in the cord blood of the fetus at delivery as well as in the breast milk of mothers on day 3 post partum. There were no adverse effects of the drug on the infants and significant hypotension did not occur. 4 The results suggest that labetalol has a direct action on fetal lung maturation and this, together with its effective hypotensive effect, contributes to the low perinatal mortality (3.5%) observed. 5 Oculotoxicity due to the labetalol was not observed in the infants delivered. 6 It is concluded that the efficient hypotensive action of labetalol, together with apparent freedom from maternal and fetal side-effects, and consequent improved perinatal mortality, suggest that it is a suitable drug for use in pregnancy complicated by hypertension.

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“…Perinatal mortality has been shown to be lower in mild pregnancy-induced hypertensive patients than in the total hospital population (Symonds, 1979). When moderate or severe hypertension occurs with proteinurea, mortality rates are raised and active treatment results in a lower perinatal mortality rate (Leather et al, 1968). Severe hypertension during pregnancy has been shown to damage small arteries and arterioles quickly (Golby & Beilin, 1972) and is a direct threat to maternal well-being.…”

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confidence: 99%

Use of labetalol and methyldopa in pregnancy‐induced hypertension.

Lamming¹,

Symonds²

1979

Brit J Clinical Pharma

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1 Nineteen pregnant patients whose mean arterial pressure (MAP) was persistently greater than or equal to 103.3 mmHg were given labetalol or methyldopa. 2 Singificant falls (P less than 0.001) in BP only occurred in the group treated with labetalol, and daily BP control was better in this group. 3 Two severely hypertensive patients were successfully treated with intravenous labetalol. 4 There was a higher incidence of spontaneous labour in the labetalol group and a significant difference (P less than 0.05) in the Bishop score of the cervix between the two groups. 5 There were no apparent detrimental effects on the foetus antenatally, during labour or post partum. 6 Slight breathlessness in one patient treated with labetalol was the only side‐effect observed but drowsiness, headache and postural hypotension were reported in patients receiving methyldopa.

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A Controlled Trial of Hypotensive Agents in Hypertension in Pregnancy

Cited by 6 publications

References 0 publications

Comparative evaluation of antihypertensive drugs in the management of pregnancy-induced hypertension

Comparative evaluation of antihypertensive drugs in the management of pregnancy-induced hypertension

Use of labetalol in the treatment of severe hypertension during pregnancy.

Use of labetalol and methyldopa in pregnancy‐induced hypertension.

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