Drugs for treatment of very high blood pressure during pregnancy

Duley, Lelia; Henderson‐Smart, David J; Meher, Shireen

doi:10.1002/14651858.cd001449.pub2

Cited by 193 publications

(161 citation statements)

References 67 publications

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“…For severe hypertension, intravenous labetalol has been observed to produce less maternal symptoms such as hypotension, palpitations and tachycardia than intravenous hydralazine but is more associated with foetal bradycardia [112,113]. A meta-analysis of 24 trials found no significant difference between parenteral labetalol and hydralazine in either effectiveness or safety profile in the context of use in severe hypertension [114]. Similarly, a systematic review of 15 randomised controlled trials on treatment of severe hypertension in pregnancy and the post-partum reported that nifedipine, labetalol and hydralazine achieved similar treatment success in most women, with no differences in adverse maternal or foetal outcomes [115].…”

Section: Intravenous Antihypertensives For Acute Crisismentioning

confidence: 99%

Hypertension in Pregnancy: Natural History and Treatment Options

et al. 2015

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Hypertensive disorders of pregnancy affect approximately 5-10% of all maternities and are major contributors of maternal and neonatal morbidity and mortality worldwide. This group of disorders encompasses chronic hypertension, as well as conditions that arise de novo in pregnancy: gestational hypertension and pre-eclampsia. The latter group is thought to be part of the same continuum but with arbitrary division. Research into the aetiology of hypertension in pregnancy have largely been focused on pre-eclampsia, with a majority of studies exploring either pregnancy-associated factors such as placental-derived or immunologic responses to pregnancy tissue, or maternal constitutional factors such as cardiovascular health and endothelial dysfunction. The evidence base for the pathophysiology and progression of hypertensive disorders in pregnancy, particularly pre-eclampsia, is reviewed. Clinical algorithms and pharmacological agents for the management of hypertension in pregnancy are summarised, with a brief focus on post-partum considerations and long-term health implications. Novel therapeutic options for the management of pre-eclampsia are also explored.

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Section: Intravenous Antihypertensives For Acute Crisismentioning

confidence: 99%

Hypertension in Pregnancy: Natural History and Treatment Options

et al. 2015

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“…In an alternative meta-analytic approach, in which each antihypertensive therapy was compared with another, calcium channel blockers were associated with less persistent, severe hypertension than was hydralazine (and ketanserin was associated with more), but few other conclusions could be drawn because of restricted sample size (24 trials, 2949 women) [40].…”

Section: Agents For Treatment Of Severe Hypertensionmentioning

confidence: 99%

Control of hypertension in pregnancy

Magee

Abalos²,

Dadelszen³

et al. 2009

Current Science Inc

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The hypertensive disorders of pregnancy are a leading cause of maternal mortality and morbidity. Complications are not limited to preeclampsia but also complicate both preexisting hypertension and isolated gestational hypertension. Blood pressure (BP) management is important but is only one aspect of management of the hypertensive disorders of pregnancy, which may be caused or exacerbated by underlying uteroplacental mismatch between maternal supply and fetal demand. BP treatment thresholds and goals vary in international guidelines, largely reflecting differences in opinion rather than differences in published data. Because of short-term maternal risks, there is consensus that BP should be treated when sustained at greater than or equal to 160 to 170 mm Hg systolic and/or 110 mm Hg diastolic. There is no consensus regarding management of nonsevere hypertension, and randomized controlled trials involving just over 3000 women have not clarified the relative maternal and perinatal risks and benefits. Although antihypertensive therapy may decrease transient severe maternal hypertension, therapy may also impair fetal growth and perinatal health and outcomes. The CHIPS Trial (Control of Hypertension In Pregnancy Study) is recruiting to answer this question.

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“…B. vorbestehende Epilepsie, zurückzuführen sind [23]. Diese schwerste Komplikation einer meist nicht ausreichend therapierten Präeklampsie tritt gewöhnlich unvorhergesehen und ohne Vorwarnung bei oft sonst asymptomatischen Schwangeren auf, ist aber nur in etwa 50% mit schwerer Hypertonie assoziiert und selbst bei fehlender Hypertonie oder Proteinurie möglich (14-34% der Fälle; [6,15] [24]. Erfahrungen bei Schwangeren zeigen, dass die Abgrenzung zur Eklampsie schwierig ist [25].…”

Section: Eklampsieunclassified