Arterial hypertension in pregnant women. What, why and with what are we treating?

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Making use of these published papers and their own long-term experience, the authors consider the problem of the treatment of pregnant women with arterial hypertension. Attention is drawn to the fact that strict control of the level of arterial pressure can worsen perinatal outcomes, due to a decrease in uterine placental perfusion. Currently, three groups of drugs are used for the treatment of pregnant women with arterial hypertension: central action drugs, calcium antagonists, and cardioselective β-adrenoceptor blockers. The use of methyldopa as a drug of choice for the treatment of pregnant women is considered in detail. It is emphasized that use of this drug causes severe complications (CNS lesion, liver problems, and autoimmune hemolytic anemia). Methyldopa should be used only in the case of mild arterial hypertension and with adequate effectiveness of treatment. In moderate to severe arterial hypertension and in cases of ineffective methyldopa treatment, calcium antagonists, β- and possibly α-adrenoceptor blockers in the form of mono- or combination therapy should be prescribed immediately.

Keywords:

pregnancy

arterial hypertension

central action drugs (methyldopa)

calcium antagonists

cardioselective β-adrenoceptor blockers

a drug with mixed α- and β-blocking action

Authors:

Mravian S.R.

Moskovskiĭ oblastnoĭ NII akusherstva i ginekologii

Petrukhin V.A.

Moskovskiĭ oblastnoĭ NII akusherstva i ginekologii

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