The treatment of hypertension in pregnancy.
The hypertensive disease that occurs during pregnancy is a multifaceted clinical condition whose accurate diagnosis, not limited to the evaluation of degree of the hypertensive derangement, is crucial for a correct therapeutic approach. In particular, chronic hypertension pre-existing before pregnancy should be clearly differentiated from the hypertensive disease induced by pregnancy and particularly from pre-eclampsia. Non-pharmacological measures of intervention have not been proven to improve both maternal and fetal outcome. Severe hypertension during pregnancy (blood pressure > 170/110 mmHg) should be immediately treated with drugs that have been proven to prolong pregnancy and to improve both maternal and fetal outcome. In patients with mild to moderate hypertension, both chronic and pregnancy induced, antihypertensive treatment improves the maternal outcome, whereas no clear-cut evidence of benefit have been reported at the fetal level. Among the different antihypertensive drugs that have been reported to be effective, safe and well tolerated during pregnancy, methyldopa, beta-blockers and particularly calcium channel blockers (nifedipine) represent the more suitable solution.
Department of Internal Medicine, University of Bologna, Bologna, Italy. claudio@med.unibo.it
Claudio
C
Borghi
Daniela Degli
DD
Esposti
Alberto
A
Cassani
Vincenzo
V
Immordino
Luciano
L
Bovicelli
Ettore
E
Ambrosioni
D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D008429:Maternal Welfare; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy* / Q000209:etiology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D000959:Antihypertensive Agents