Treating Blood Pressure in Pregnancy
Some women will have raised blood pressure (hypertension) and on medication when
they conceive. If it is a planned pregnancy, the woman may wish to have her medication
is reviewed to ensure what she is taking is safe for when she has successfully conceived.
Others might need anti-hypertensive medication if they develop the pregnancy complication
known as pre-eclampsia.
Ø Methyl-dopa (Aldomet®) is one of the most common antihypertensives used in pregnancy.
It has been around for many years. It is known to be safe.
Ø Beta-blockers (ß-blockers) is a group of drugs also used commonly for the treatment
of raised blood pressure (hypertension). These include propranolol (Inderal®), acebutolol
(Sectral®), atenolol (Tenormin®), oxprenolol (Trasicor®) and labetalol (a partial
beta-blocker). There are many other beta-blockers. Overall, these are regarded to
be safe. There is a small possibility that long term use in pregnancy could cause
intrauterine growth restriction but this is usually outweighed by the potential benefits.
Use just before delivery has also been associated with the fall of blood sugar levels
in the baby (neonatal hypoglycaemia). The pediatricians therefore need to be informed
of the mother's use of these drugs so the appropriate surveillance on the newborn
can be maintained.
Ø Hydralazine: This is used only for short-term lowering of blood pressure, usually
in late pregnancy. For this, it is known to be safe. Occasionally it has been associated
with fall in platelet count in the newborn, but this spontaneously recovers in about
two or three weeks.
Ø Nifedipine: This belongs to a group of drugs known as calcium channel blockers.
It is also used for short-term lowering of blood pressure in pregnancy and to try
to suppress uterine activity in threatened preterm labor. For this, it is known to
be safe. Regular or long term use in pregnancy should be avoided if possible, as
safety for the fetus cannot be guaranteed. However, no adverse effects have been
reported and benefits should always be weighed against potential risks. Other calcium
channel blockers include Nimodipine (Nimotop®), Felodipine (Plendil®), Amlodipine
(Istin®), Diltiazem (Tildiem®) and several others.
Using "ACE-inhibitors" in pregnancy
ACE-inhibitors such as captopril (Capoten®), enalapril (Innovace®), Cilazapril (
Vascace®),
lisinopril (Carace®, Zestril®), quinapril (Accupro®) and a few others are very effective
anti-hypertensives. They are not used in pregnancy. In fact, any woman taking these
who is planning to conceive should be weaned off them and put on something else (such
as a beta blocker or methyl-dopa). Use in the first trimester has been associated
with major cardiac (heart) and central nervous system malformations in the fetus.
Diuretics in pregnancy: Next Page
