Beta-blockers appear to be no more effective and probably equally as safe .
It is unusual for women to change drugs due to side effects .
REVIEW ER 'S CONCLUSIONS Improvement in control of maternal blood pressure with use of beta-blockers would be worthwhile only if it were reflected in substantive benefits for mother and /or baby , and none have been clearly demonstrated .
Large r and omised trials are needed to determine whether antihypertensive therapy in general ( rather than beta-blocker therapy specifically ) results in greater benefit than risk , for treatment of mild-moderate pregnancy hypertension .
BACKGROUND Antihypertensives , such as beta-blockers , are used for pregnancy hypertension in the belief these will improve outcome for mother and baby .
OBJECTIVES To assess whether oral beta-blockers are better than placebo , or no beta-blocker , and have advantages over other antihypertensives , for women with mild to moderate pregnancy hypertension .
A comparison of no medication versus methyldopa or labetalol in chronic hypertension during pregnancy.
Three hundred women with mild chronic hypertension at 6 to 13 weeks ' gestation were r and omly allocated to receive either methyldopa or labetalol or be in the control group . Thirty-seven women ( 12 % ) were excluded for various reasons . Of the remaining 263 patients , 90 received no drug , 87 received methyldopa , and 86 received labetalol . All 263 were followed throughout pregnancy with serial renal function tests and serial assessment of fetal status . There were no differences among the three groups in mean systolic or diastolic blood pressures , mean gestational age , or initial laboratory findings at time of entry . Patients treated with medications had significantly lower ( p less than 0.0001 ) systolic and diastolic blood pressures throughout gestation compared with the no-medication group . Among the control group there was a spontaneously significant lowering ( p less than 0.0001 ) of both systolic and diastolic blood pressures at 14 to 26 weeks ' gestation . However , there were no differences among the three groups regarding the incidences of either superimposed preeclampsia ( 15.6 % , 18.4 % , and 16.3 % , respectively ) , abruptio placentae ( 2.2 % , 1.1 % , and 2.3 % , respectively ) , or preterm delivery ( 10 % , 12.5 % , and 11.6 % , respectively ) . In addition , there were no differences among the groups regarding gestational age at delivery , birth weight , incidence of fetal growth retardation , or neonatal head circumference . There was one midtrimester loss in the methyldopa group and one stillbirth in each of the other groups . We conclude that treatment of maternal blood pressure in mild chronic hypertension during pregnancy did not improve perinatal outcome
Beta-blockers appear to be no more effective and probably equally as safe .
It is unusual for women to change drugs due to side effects .
REVIEW ER 'S CONCLUSIONS Improvement in control of maternal blood pressure with use of beta-blockers would be worthwhile only if it were reflected in substantive benefits for mother and /or baby , and none have been clearly demonstrated .
Large r and omised trials are needed to determine whether antihypertensive therapy in general ( rather than beta-blocker therapy specifically ) results in greater benefit than risk , for treatment of mild-moderate pregnancy hypertension .
BACKGROUND Antihypertensives , such as beta-blockers , are used for pregnancy hypertension in the belief these will improve outcome for mother and baby .
OBJECTIVES To assess whether oral beta-blockers are better than placebo , or no beta-blocker , and have advantages over other antihypertensives , for women with mild to moderate pregnancy hypertension .