Effects of methyldopa on uteroplacental and fetal hemodynamics in pregnancy-induced hypertension

Montán, Sven; Anandakumar, C.; Arulkumaran, Sabaratnam; Ingemarsson, Ingemar; Ratnam, S. S.

doi:10.1016/s0002-9378(12)90905-9

Cited by 81 publications

(44 citation statements)

References 20 publications

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“…It was similar to a study done on the comparison of nifedipine with methyldopa in Srilanka on 126 PIH patients where the systolic and diastolic BP for nifedipine and methyldopa were significantly reduced from base to end [5]. The same result found with the study conducted at a national university hospital, Singapore, concluded that short-term treatment with methyldopa significantly reduced the maternal blood pressure [6].…”

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confidence: 85%

Comparison of Treatment Outcome of Antihypertensive Drugs in the Management of Pregnancy Induced Hypertension

Velusamy

2017

Int J Pharm Pharm Sci

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This study was aimed to find out the differences in the pregnancy outcome of PIH women treated with the antihypertensive drugs methyldopa and nifedipine. The prospective observational study was conducted in a multi specialty hospital at Coimbatore with 161 PIH diagnosed women. Women were categorised into the no-drug group, methyldopa group, nifedipine group and methyldopa with nifedipine group. All the women were monitored from diagnosis to delivery. The maternal and neonatal data were collected and analysed. The drugs were significantly controlled the blood pressure (BP) from base to end (P<0.001). There was no significant difference in the reduction of BP between the drugs. Cesarean delivery (>90%) and preterm delivery were high across all the groups. No significant difference was seen between these groups. The AGA (Average for gestational age) babies were significantly higher with a no-drug group (83%) and lower with nifedipine group (40%). Two women were reported with HELLP syndrome in methyldopa with nifedipine group. No significant difference was found in terms of pregnancy outcome between these groups except for eclampsia and AGA. Eclampsia was affected more with 14% in methyldopa with nifedipine group. We found similar outcomes; there were no significant changes between methyldopa, nifedipine, and the no-drug treatment. The antihypertensive drugs nifedipine and methyldopa both were significantly reduced the BP. The maternal and neonatal complications were similar between these two drugs. No beneficial effect can be identified one over another. Pregnancy-induced hypertension (PIH) is associated with the various problems in pregnancy outcome. The complications of high blood pressure (BP) during pregnancy are detrimental [1]. The elevated or uncontrolled BP leads to early and cesarean delivery also caused various complications to both mother and fetus. Indeed, the PIH resolves postpartum it causes various maternal and fetal morbidity and mortality [2]. Growth retardation and fetal mortality are the serious complications in PIH pregnancy. The development of PIH often required medications to control the BP. Antihypertensive drugs are used to control the BP within the normal range which further reduces the PIH related complications. Although various drugs are used to treat the PIH, the benefits of antihypertensive medication in PIH is inconsistent [3] and the use of antihypertensive medication as well as treatment targets in PIH remains controversial [4]. The chosen drug should be safe and effective to both mother and fetus in terms of reduction in PIH complications. Hence this study was planned to find out the differences in treatment outcome between the different types of antihypertensive drugs used in the treatment of PIH.The study was approved by the Institutional ethics committee (EC/AP/102/09-2009, Date: 12-08-2009) at kovai medical center and hospital, Coimbatore, Tamilnadu, India. The observational study was carried out at kovai medical center and hospital from January 2009 to December 2014. A ...

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confidence: 85%

Comparison of Treatment Outcome of Antihypertensive Drugs in the Management of Pregnancy Induced Hypertension

Velusamy

2017

Int J Pharm Pharm Sci

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“…Methyldopa was firstchoice therapy based on reports of stable utero-placental blood flow, fetal hemodynamics (11,12), and long-term follow-up (13). Given that the prevalence of preterm delivery and preeclampsia was still high (5), we speculated that pregnant type 1 diabetic women with microalbuminuria or diabetic nephropathy would benefit from further intensified antihypertensive therapy in early pregnancy.…”

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confidence: 99%

Improved Pregnancy Outcome in Type 1 Diabetic Women With Microalbuminuria or Diabetic Nephropathy

2009

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OBJECTIVE -To describe pregnancy outcome in type 1 diabetic women with normoalbuminuria, microalbuminuria, or diabetic nephropathy after implementation of an intensified antihypertensive therapeutic strategy.RESEARCH DESIGN AND METHODS -Prospective study of 117 pregnant women with type 1 diabetes. Antihypertensive therapy, mainly methyldopa, was given to obtain blood pressure Ͻ135/85 mmHg and urinary albumin excretion Ͻ300 mg/24 h. Blood pressure and A1C were recorded during pregnancy. The pregnancy outcome was compared with recently published studies of pregnant women with microalbuminuria or diabetic nephropathy.RESULTS -Antihypertensive therapy was given in 14 of 100 women with normoalbuminuria, 5 of 10 women with microalbuminuria, and all 7 women with diabetic nephropathy. Mean systolic blood pressure during pregnancy was 120 mmHg (range 101-147), 122 mmHg (116 -135), and 135 mmHg (111-145) in women with normoalbuminuria, microalbuminuria, and diabetic nephropathy, respectively (P ϭ 0.0095). No differences in mean diastolic blood pressure or A1C were detected between the groups. No women with microalbuminuria developed preeclampsia. The frequency of preterm delivery was 20% in women with normoalbuminuria and microalbuminuria in contrast to 71% in women with diabetic nephropathy (P Ͻ 0.01) where the median gestational age was 258 days (220 -260). Compared with previous studies using less stringent antihypertensive therapeutic strategy and less strict metabolic control, gestational age was longer and birth weight was larger in our study.CONCLUSIONS -With intensified antihypertensive therapy and strict metabolic control, comparable pregnancy outcome was seen in type 1 diabetic women with microalbuminuria and normoalbuminuria. Although less severe than in previous studies, diabetic nephropathy was associated with more adverse pregnancy outcome. Diabetes Care 32:38-44, 2009

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“…Doppler ultrasonography blood flow data before and after one week of methyldopa treatment showed no change in uterine artery indices, umbilical artery indices and middle cerebral artery indices. 11 Adiga et al has also reported similar findings.…”

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confidence: 56%

Study of Color Doppler of Uterine Artery, Umbilical Artery, Middle Cerebral Artery in PIH Patients on Antihypertensive Therapy

Gaur¹

2017

jmscr

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Effects of methyldopa on uteroplacental and fetal hemodynamics in pregnancy-induced hypertension

Cited by 81 publications

References 20 publications

Comparison of Treatment Outcome of Antihypertensive Drugs in the Management of Pregnancy Induced Hypertension

Comparison of Treatment Outcome of Antihypertensive Drugs in the Management of Pregnancy Induced Hypertension

Improved Pregnancy Outcome in Type 1 Diabetic Women With Microalbuminuria or Diabetic Nephropathy

Study of Color Doppler of Uterine Artery, Umbilical Artery, Middle Cerebral Artery in PIH Patients on Antihypertensive Therapy

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