Penggunaan Anti-Hipertensi Sebagai Terapi Untuk Hipertensi Selama Kehamilan : Telaah Pustaka Sistematik

Abstract

The risk of complications and poor maternal and fetal outcomes caused by hypertension during pregnancy can be prevented by controlling blood pressure through anti-hypertensive therapy. The aim of this study was to provide an overview of the use of anti-hypertensive drugs based on efficacy and safety in cases of hypertension during pregnancy. The study design was systematic literature review conducted following PRISMA guidelines. Article search method using electronic databases MEDLINE (PubMed) and Cochrane Library and was performed up until August 2021. Search strategies used keywords following the topic of study. Articles were selected by title and abstract followed by full text according to the inclusion and exclusion criteria. There were 8 articles that met the inclusion criteria include 1325 participants. Anti-hypertensive drugs that can be used include IV urapidil, IV dihydralazine, IV nicardipine, oral methyldopa, oral isradipine, oral nifedipine, and oral labetalol. Urapidil was better in controlling high blood pressure than dihydralazine, although the results of the blood pressure reduction effect were not as strong as nicardipine. However, urapidil had better safety than dihydralazine and nicardipine. In addition, methyldopa had no significant difference in efficacy for lowering blood pressure compared to labetalol and isradipine. Based on the results of the literature review it can be concluded that there were several choices of anti-hypertensive drugs that can be used as hypertension therapy during pregnancy. The results showed an effective reduction in blood pressure from the use of anti-hypertension in patients with hypertension during pregnancy. The use of IV dihydralazine was at risk of increased heart rate while the risk of maternal hypotension was higher in the use of IV nicardipine.