Question

A woman who is 32 weeks pregnant has developed significant hypertension which must be treated. What medication options does the Nurse Practitioner have and why ? What medications cannot be used in this situation and why?

Answer 1

Ans.

Hypertension pregnancy treatment

Intravenous (IV) labetalol and hydralazine have long been considered first-line medications for the management of acute-onset, severe hypertension in pregnant women and women in the postpartum period. Available evidence suggests that oral nifedipine also may be considered as a first-line therapy.

According to NHBPEP methyldopa, labetalol, beta blockers (other than atenolol), slow release nifedipine, and a diuretic in pre-existing hypertension are considered as appropriate treatment [.. For emergency treatment in preeclampsia, IV hydralazine, labetalol and oral nifedipine can be used .

Approximately 1% of pregnancies are complicated by essential hypertension. During pregnancy the blood pressure often stabilizes or improves. ... Such medication must be chosen carefully to avoid fetal and mateerial toxicity, and diuretics and salt restriction during pregnancy should be avoided.

Contraindicated in pregnancy -

Renin Angiotensin System drugs

Angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARB) are contraindicated in pregnancy due to their association with adverse fetal effects