Hydralazine was the most common drug for others to be evaluated against .
Diazoxide , given as 75 mg bolus injections , appears to be associated with maternal hypotension requiring treatment , and ketanserin is less effective than hydralazine at reducing blood pressure .
There is no other clear evidence that any one of the other antihypertensive agents is better than another for women with severe hypertension during pregnancy .
Exceptions are diazoxide and ketanserin , which are probably not good choices
BACKGROUND Very high blood pressure during pregnancy poses a serious threat to women and their babies .
The use of drugs to lower blood pressure will reduce this risk for the women , and possibly also for the baby .
OBJECTIVES The objective of this review was to compare different antihypertensive drugs used for treatment of severe hypertension during pregnancy .
A comparative trial of labetalol and hydralazine in the acute management of severe hypertension complicating pregnancy.
Sixty peripartum patients with diastolic blood pressures ( BP ) 110 mmHg or higher were r and omized in a 2:1 ratio to receive repeated intravenous injections of either labetalol ( 20 - 80 mg ) or hydralazine ( 5 mg ) until the diastolic BP was below 100 mmHg . There were four treatment failures in the labetalol group ( N = 40 ) and none in the hydralazine group ( N = 20 ) . Hydralazine lowered mean arterial pressure ( MAP ) more than did labetalol ( 33.3 + /- 13.2 versus 25.5 + /- 11.2 mmHg ; mean + /- SD ) , but labetalol had a more rapid effect . There was considerable interpatient variability in the dose of labetalol required to control BP , which could not be predicted by any clinical characteristic before therapy . The duration of action also varied in the labetalol group , with the shortest duration occurring in those patients who required the highest dosage for BP control . No significant fetal or neonatal problems ascribable to drug treatment were noted in the 13 instances in which labetalol was given before delivery . However , fetal distress occurred in two of the six cases involving antenatal hydralazine . We conclude that labetalol appears to be a safe and effective alternative to hydralazine for treating hypertension in the peripartum period , but serious rare side effects have not yet been quantified
Hydralazine was the most common drug for others to be evaluated against .
Diazoxide , given as 75 mg bolus injections , appears to be associated with maternal hypotension requiring treatment , and ketanserin is less effective than hydralazine at reducing blood pressure .
There is no other clear evidence that any one of the other antihypertensive agents is better than another for women with severe hypertension during pregnancy .
Exceptions are diazoxide and ketanserin , which are probably not good choices
BACKGROUND Very high blood pressure during pregnancy poses a serious threat to women and their babies .
The use of drugs to lower blood pressure will reduce this risk for the women , and possibly also for the baby .
OBJECTIVES The objective of this review was to compare different antihypertensive drugs used for treatment of severe hypertension during pregnancy .