Hostname: page-component-6bf8c574d5-685pp Total loading time: 0 Render date: 2025-03-09T23:27:52.610Z Has data issue: false hasContentIssue false
  • English
  • Français

Antihypertensive therapy during pregnancy

Published online by Cambridge University Press:  10 October 2008

Radha S Chari ,
Steven A Friedman  and
Baha M Sibai
Radha S Chari
Affiliation:
Department of Obstetrics and Gynecology, University of Tennessee, USA.
Steven A Friedman
Affiliation:
Department of Obstetrics and Gynecology, University of Tennessee, USA.
Baha M Sibai*
Affiliation:
Department of Obstetrics and Gynecology, University of Tennessee, USA.
*
Baha M Sibai, Professor & Chief, Division of Maternal-Fetal Medicine, University of Tennessee, 853 Jefferson Avenue, Memphis, TN 38163, USA.
Get access Rights & Permissions [Opens in a new window]

Extract

Hypertensive disorders in pregnancy are a leading cause of maternal and perinatal morbidity and mortality. Overall, hypertension complicates approximately 10% of pregnancies. The incidence is higher in patients with predisposing factors including nulliparity, multiple gestation, preexisting hypertension or diabetes, a previous pregnancy complicated by preeclampsia-eclampsia, familial history of preeclampsia, hydrops fetalis and rapidly growing hydatidiform moles.

Type
Articles
Information
Fetal and Maternal Medicine Review , Volume 7 , Issue 2 , May 1995 , pp. 61 - 76
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Druzin, ML. Pregnancy induced hypertension and preeclampsia: the fetus and the neonate. In: Rubin, PC ed, Handbook of hypertension volume 10: hypertension in pregnancy. Amsterdam: Elsevier, 1988: 267–89.Google Scholar
2 National High Blood Pressure Education Program Working Group. Report on high blood pressure in pregnancy. Am J Obstet Gynecol 1990; 163: 1689–712.Google Scholar
3Cunningham, GF. Hypertensive disorders in pregnancy. In: Cunningham, GF, MacDonald, PC, Gant, NF, Leveno, KJ, Gilstrap, LC eds. Williams Obstetrics. 19th edition. Connecticut, USA: Appleton and Lange, 1993: 763–818.Google Scholar
4Svensson, A. Hypertension in pregnancy. Clin Exp Hypertens 1993; 15: 1353–61.CrossRefGoogle ScholarPubMed
5Chesley, LC. Hypertensive disorders in pregnancy. New York: Appleton-Century-Crofts, 1978.Google Scholar
6Sibai, BM, Usta, IM. Chronic hypertension in pregnancy. In: Sciarra, JJ ed. Obstetrics and Gynecology, 4th edition. New York: Churchill Livingstone, 1995: in press.Google Scholar
7Sibai, BM, Anderson, GD. Pregnancy outcome of intensive therapy in severe hypertension in first trimester. Obstet Gynecol 1986; 67: 517–22.Google ScholarPubMed
8Leather, HM, Humphreys, DM, Baker, PB, Chadd, MA. A controlled trial of hypotensive agents in hypertension in pregnancy. Lancet 1968; 2: 488–90.CrossRefGoogle ScholarPubMed
9Redman, CWE, Beilin, LJ, Bonnar, J. Fetal outcome in a trial of antihypertensive treatment in pregnancy. Lancet 1976; i: 753–56.CrossRefGoogle Scholar
10Arias, F, Zamora, J. Antihypertensive treatment and pregnancy outcome in patients with mild chronic hypertension. Obstet Gynecol 1979; 53: 489–94.Google ScholarPubMed
11Weitz, C, Khouzami, V, Maxwell, K, Johnson, JWC. Treatment of hypertension in pregnancy with methyldopa: a randomized double-blind study. Int J Gynecol Obstet 1987; 25: 35.CrossRefGoogle ScholarPubMed
12Sibai, BM, Mabie, WC, Shamsa, F, Villar, MA, Anderson, GD. A comparision of no medication versus methyldopa or labetalol in chronic hypertension during pregnancy. Am J Obstet Gynecol 1990; 162: 906–907.CrossRefGoogle ScholarPubMed
13Butters, L, Kennedy, S, Rubin, PC. Atenolol in essential hypertension during pregnancy. Br Med J 1990; 301: 587–89.CrossRefGoogle ScholarPubMed
14Gallery, EDM, Saunders, DM, Hunyor, SN, Gyory, AZ. Randomised comparision of methyldopa and oxprenolol for treatment of hypertension in pregnancy. Br Med J 1979; 1: 1591–94.CrossRefGoogle Scholar
15Fidler, J, Smith, V, Fayres, P, de Swiet, M. Randomised controlled comparative study of methyldopa and oxprenolol in the treatment of hypertension in pregnancy. Br Med J 1983; 286: 1927–30.CrossRefGoogle ScholarPubMed
16Saotome, T, Minoura, S, Terashi, K, Sato, T, Echizen, H, Ishizaki, T. Labetalol in hypertension during the 3rd trimester of pregnancy: its antihypertensive effect and pharmacokinetic-dynamic analysis. J Clin Pharmacol 1993; 33: 979–88.CrossRefGoogle ScholarPubMed
17Kaja, R, Hiilesmaa, V, Holma, K, Jarvenpaa, AL. Maternal antihypertensive therapy with beta blockers associated with poor outcome in very low birth weight infants. Int J Gynecol Obstet 1992; 38: 195–99.CrossRefGoogle Scholar
18Mabie, WC, Pernoll, ML, Biswas, NK. Chronic hypertension in pregnancy. Obstet Gynecol 1986; 67: 197–205.CrossRefGoogle ScholarPubMed
19Branch, DW, Silver, RM, Blackwell, JL, Reading, JC, Scott, JR. Outcome of treated pregnancies in women with antiphospholipid syndrome: an update of the UTAH experience. Obstet Gynecol 1992; 80: 614–20.Google ScholarPubMed
20Abe, S, Amagesaki, Y, Konishi, K, Kato, E, Sakaguchi, H, Iyori, S. The influence of antecedent renal disease on pregnancy. Am J Obstet Gynecol 1985; 153: 508–14.CrossRefGoogle ScholarPubMed
21Hou, SH, Grossman, SD, Madias, NE. Pregnancy in women with renal disease and moderate renal insufficiency. Am J Med 1985; 78: 185–94.CrossRefGoogle ScholarPubMed
22Mabie, WC, Ratts, TE, Ramanathan, KB, Sibai, BM. Circulatory congestion in obese hypertension: a subset of pulmonary edema in pregnancy. Obstet Gynecol 1988; 71: 553–58.Google Scholar
23Are Ace inhibitors safe in pregnancy?. Lancet 1989; ii: 482.Google Scholar
24Smith, AM. Letter: are Ace inhibitors safe in pregnancy?. Lancet 1989; ii: 750–51.CrossRefGoogle Scholar
25Rosa, F, Bosco, W, Graham, CF, Milstein, JB, Dreis, N, Creamer, J. Neonatal anuria with maternal angiotensin converting enzyme inhibition. Obstet Gynecol 1989; 74: 371–74.Google ScholarPubMed
26Scott, AA, Purohet, DM. Neonatal renal failure: a complication of maternal antihypertensive therapy. Am J Obstet Gynecol 1989; 160: 1223–41.CrossRefGoogle ScholarPubMed
27Cunningham, FG, Leveno, KJ. Management of pregnancy-induced hypertension. In: Rubin, PC ed, Handbook of hypertension volume 10. Hypertension in pregnancy. Amsterdam: Elsevier, 1988: 290–319.Google Scholar
28MacGillivray, I. Some observations on the incidence of preeclampsia. J Obstet Gynecol Br Empire 1958; 65: 536–39.CrossRefGoogle Scholar
29Hjertberg, R, Belfrage, P, Hanson, V. Conservative treatment of mild and moderate hypertension in pregnancy. Acta Obstet Gynecol Scand 1992; 71: 439–46.CrossRefGoogle ScholarPubMed
30Sibai, BM, Gonzalez, AR, Mabie, WC, Moretti, M.. A comparison of labetalol plus hospitalization versus hospitalization alone in the management of preeclampsia remote from term. Obstet Gynecol 1987; 70: 323–27.Google ScholarPubMed
31Plouin, PF, Breart, GL, Maillard, F, Papiernik, E, Relier, JP. Comparison of antihypertensive efficacy and perinatal safety of labetalol and methyldopa in the treatment of hypertension in pregnancy: a randomised controlled trial. Br J Obstet Gynaecol 1988; 95: 868–76.CrossRefGoogle Scholar
32Pickles, CJ, Symonds, EM, Broughton-Pipkin, F. The fetal outcome in a randomised double-blind controlled trial of labetalol versus placebo in pregnancy-induced hypertension. Br J Obstet Gynaecol 1989; 96: 38–43.CrossRefGoogle Scholar
33Plouin, F, Breart, G, Llado, J, Dalle, M, Keller, ME, Goujon, H, Berchel, C. A randomised comparison of early with conservative use of antihypertensive drugs in the management of pregnancy induced hypertension. Br J Obstet Gynaecol 1990; 97: 134–41.CrossRefGoogle ScholarPubMed
34Pickles, CJ, Broughton-Pipkin, F, Symonds, EM. A randomised placebo controlled trial of labetalol in the treatment of mild to moderate pregnancy induced hypertension. Br J Obstet Gynaecol 1992; 99: 964–68.CrossRefGoogle ScholarPubMed
35Rubin, PC, Clark, DM, Sumner, DJ, Low, RA, Butters, L, Reynolds, B et al. Placebo-controlled trial of atenolol in the treatment of pregnancy associated hypertension. Lancet 1983; i: 431–34.Google Scholar
36Wichman, K, Ryden, G, Karlberg, BE. A placebo controlled trial of metoprolol in the treatment of hypertension in pregnancy. Scand J Clin Lab Invest 1984; 44: 90–95.CrossRefGoogle Scholar
37Cruikshank, DJ, Robertson, AA, Campbell, DM, MacGillivray, I. Does labetolol influence the development of proteinuria in pregnancy hypertension? A randomized controlled study. Eur J Obstet Gynecol 1992; 45: 47–51.CrossRefGoogle Scholar
38Phippard, AF, Fischer, WE, Horvath, JS, Child, AG, Korda, AR, Henderson-Smart et al. Early blood pressure control improves pregnancy outcome in primigravid women with mild hypertension. Med J Aust 1991; 154: 378–82.CrossRefGoogle ScholarPubMed
39Sibai, BM, Barton, JR, Akl, S, Sarinoglu, C, Mercer, BM. A randomized prospective comparision of management of preeclampsia remote from term. Am J Obstet Gynecol 1992; 167: 879–84.CrossRefGoogle Scholar
40Blake, S, MacDonald, D. The prevention of the maternal manifestations of preeclampsia by intensive antihypertensive treatment. Br J Obstet Gynaecol 1991; 98: 244–48.CrossRefGoogle ScholarPubMed
41Jannet, D, Carbonne, B, Sebban, E, Milliez, J. Nicardipine versus metoprolol in the treatment of hypertension during pregnancy: a randomized controlled trial. Obstet Gynecol 1994; 84: 354–59.Google Scholar
42Mabie, WC, Gonzales, AR, Sibai, BM, Amon, E. A comparative trial of labetalol and hydralazine in the acute management of severe hypertension complicating pregnancy. Obstet Gynecol 1987; 70: 328–33.Google ScholarPubMed
43Fenakel, K, Fenakel, G, Appleman, Z, Lurie, S, Katz, Z, Shoham, Z. Nifedipine in the treatment of severe preeclampsia. Obstet Gynecol 1991; 77: 331–37.Google ScholarPubMed
44Moodely, J, Gouws, E. A comparative study of the use of epoprostenol and dihydralazine in severe hypertension in pregnancy. Br J Obstet Gynecol 1992; 99: 727–30.CrossRefGoogle Scholar
45Odendaal, H, Pattinson, R, Bam, R, Grove, D, Kotze, T. Aggressive or expectant management for patients with severe preeclampsia between 28 to 34 weeks gestation: a randomized controlled trial. Obstet Gynecol 1990; 76: 1070–74.Google ScholarPubMed
46Sibai, BM, Mercer, BM, Schiff, E, Friedman, SA. Aggressive versus expectant management of severe preeclampsia at 28 to 32 weeks gestation. A randomized controlled trial. Am J Obstet Gynecol 1994; 171: 818–22.CrossRefGoogle ScholarPubMed
47Sibai, BM, Akl, S, Fairlie, F, Moretti, M. A protocol for managing severe preeclampsia in the second trimester. Am J Obstet Gynecol 1990; 163: 733–38.CrossRefGoogle ScholarPubMed
48Walss-Rodriguez, RJ, Flores-Padilla, LM. Management of severe preeclampsia/eclampsia. Comparision between nifedipine and hydralizine as antihypertensive agents. Ginecol Obstet Mex 1993; 61: 76–79.Google Scholar
49Cockburn, J, Moar, VA, Ounsted, NM, Redman, CWG. Final repord of study on hypertension during pregnancy: the effects of specific treatment on the growth and development of the children. Lancet 1982; i: 647–49.CrossRefGoogle Scholar
50Horvath, JS, Phippard, A, Korda, A, Henderson-Smart, DJ, Child, A, Tiller, DJ. Clonidine-hydrochloride: a safe and effective antihypertensive agent in pregnancy. Obstet Gynecol 1985; 66: 634–38.Google ScholarPubMed
51Lubbe, WF, Hodge, JV, Kellaway, GSM. Antihypertensive treatment and fetal welfare in essential hypertension in pregnancy: a retrospective survey of experience with various regimes at National Women’s Hospital, Auckland, 1970–80. NZ Med J 1982; 95: 1–5.Google ScholarPubMed
52Lindow, S, Davies, N, Davey, DA, Smith, JA. The effect of sublingual nifedipine on utero-placental blood flow in hypertensive pregnancy. Br J Obstet Gynaecol 1988; 95: 1276–81.CrossRefGoogle Scholar
53Hanretty, KP, Whittle, MJ, Howie, CA, Rubin, PC. Effect of nifedipine on Doppler flow velocity waveforms in severe preeclampsia. Br Med J 1989; 299: 1205–206.CrossRefGoogle Scholar
54Moretti, MM, Fairlie, FM, Akl, S, Khaury, A, Sibai, BM. The effect of nifedipine therapy on fetal and placental Doppler waveforms in preeclampsia remote from term. Am J Obstet Gynecol 1990; 163: 844–48.CrossRefGoogle Scholar
55Constantine, G, Beevers, DG, Reynolds, AL, Luesley, DM. Nifedipine as a second line antihypertensive drug in pregnancy. Br J Obstet Gynaecol 1987; 94: 1136–42.CrossRefGoogle ScholarPubMed
56Rubin, PC, Butters, L, McCabe, RT. Nifedipine and platelets in preeclampsia. Am J Hypertens 1988; 1: 175–77.CrossRefGoogle ScholarPubMed
57Van Zwieten, PA, Timmermans, PB. MVM: differential pharmacological properties of beta adrenoreceptor blocking drugs. J Cardiovasc Pharmacol 1983; 5(suppl 1): 51–57.CrossRefGoogle Scholar
58Collins, R, Yusuf, S, Peto, R. Overview of randomised trials of diuretics in pregnancy. Br Med J 1985; 290: 17–23.CrossRefGoogle ScholarPubMed
59Henrich, WL, Cronin, R, Miller, PP, Anderson, RD. Hypotensive sequelae of diazoxide and hydralazine therapy. J Am Med Assoc 1977; 237: 264–65.CrossRefGoogle ScholarPubMed
60Neuman, J, Weiss, B, Rabello, Y, Cabal, I, Freeman, RK. Diazoxide for the acute control of severe hypertension complicating pregnancy: a pilot study. Obstet Gynecol 1979; 53: 50–55.Google ScholarPubMed
61Dudley, DKL. Minibolus diazoxide in the management of severe hypertension in pregnancy. Am J Obstet Gynecol 1985; 151: 196–200.CrossRefGoogle ScholarPubMed
62Walters, BNJ, Redman, CWG. Treatment of severe pregnancy associated hypertension with the calcium antagonist nifedipine. Br J Obstet Gynaecol 1984; 91: 330–36.CrossRefGoogle ScholarPubMed
63Carbonne, B, Jannet, D, Touboul, C, Khelifati, Y, Milliez, J. Nicardipine treatment of hypertension during pregnancy. Obstet Gynecol 1993; 81: 908–14.Google ScholarPubMed
64Ingemarsson, I, Wide-Swensson, D, Andersson, KE, Arulkumaran, S. Maternal and fetal cardiovascular changes after intravenous injection of isradipine to pregnant women. Drugs 1990; 40: 58–59.CrossRefGoogle ScholarPubMed
65Allen, J, Maigaard, S, Forman, A, Jacobsen, P, Jespersen, LT, Hansen, KPB et al. Acute effects of nitrendipine in pregnancy induced hypertension. Br J Obstet Gynaecol 1987; 94: 222–26.CrossRefGoogle ScholarPubMed
66Belfort, MA, Saade, GR, Moise, KJ, Cruz, A, Adam, K, Kramer, W et al. Nimodipine in the management of preeclampsia: maternal and fetal effects. Am J Obstet Gynecol 1994; 171: 417–24.CrossRefGoogle ScholarPubMed
67Jouppila, P, Kirkinen, P, Koivula, A, Ylikorkala, O. Labetalol does not alter the placental and fetal blood flow or maternal prostanoids in preeclampsia. Br J Obstet Gynaecol 1986; 93: 543–47.CrossRefGoogle ScholarPubMed
68Shoemaker, CT, Meyers, M. Sodium nitroprusside for control of severe hypertensive disease of pregnancy: a case report and discussion of potential toxicity. Am J Obstet Gynecol 1984; 149: 171–73.CrossRefGoogle ScholarPubMed
69Naulty, JN, Cefalo, RJ, Lewis, PE. Fetal toxicity of nitroprusside in the pregnant ewe. Am J Obstet Gynecol 1981; 139: 708–11.CrossRefGoogle ScholarPubMed