REVIEW ER 'S CONCLUSIONS It remains unclear whether antihypertensive drug therapy for mild-moderate hypertension during pregnancy is worthwhile
BACKGROUND Mild-moderate hypertension during pregnancy is common .
Antihypertensive drugs are often used in the belief that lowering blood pressure will prevent progression to more severe disease , and thereby improve outcome .
OBJECTIVES To assess the effects of antihypertensive drug treatments for women with mild to moderate hypertension during pregnancy .
Uterine and fetal hemodynamics and fetal cardiac function after atenolol and pindolol infusion. A randomized study.
OBJECTIVE To evaluate the short-term effects of intravenously given atenolol and pindolol on utero- and umbilicoplacental vascular impedance , fetal hemodynamics and cardiac function in patients suffering from pregnancy-induced hypertension . STUDY DESIGN A total of 24 women were r and omized to receive atenolol or pindolol infusion . By using pulsed color Doppler techniques , uterine , placental arcuate , umbilical fetal middle cerebral and renal arteries were examined before , at the end and 30 min after the end of infusion . Pulsatility indices ( PI ) were calculated to assess vascular impedance . Fetal myocardial function was evaluated by using pulsed Doppler and M-mode echocardiography . Peak systolic velocities from the ascending aorta and pulmonary trunk , and also inner diameters and fractional shortenings of both ventricles were measured . RESULTS Both drugs significantly decreased maternal blood pressure . Immediately after the infusion , maternal heart rate was significantly decreased in both groups ; but the decrease was clearer and lasted longer in the atenolol group . Pindolol caused no changes in utero- or umbilicoplacental vascular impedance , while atenolol increased it in the nonplacental uterine artery . After atenolol infusion , PI in the umbilical artery was higher than after pindolol . Pindolol had no effects on fetal hemodynamics , while atenolol decreased PI value in the fetal renal artery . Peak systolic velocity in the pulmonary trunk was decreased after atenolol . Pindolol did not affect the fetal cardiac function . In subgroups with originally increased utero- or umbilicoplacental vascular impedance , the responses in uterine and umbilical vascular impedance and in fetal hemodynamics and cardiac function after atenolol and pindolol were different compared to whole groups . CONCLUSION Differently acting antihypertensive agents seem to affect differently uteroplacental vascular impedance .  Atenolol may have some direct effects on fetal hemodynamics and cardiac function . According to our results , pindolol seems to be more preferable in the treatment of pregnancy-induced hypertension than atenolol
REVIEW ER 'S CONCLUSIONS It remains unclear whether antihypertensive drug therapy for mild-moderate hypertension during pregnancy is worthwhile
BACKGROUND Mild-moderate hypertension during pregnancy is common .
Antihypertensive drugs are often used in the belief that lowering blood pressure will prevent progression to more severe disease , and thereby improve outcome .
OBJECTIVES To assess the effects of antihypertensive drug treatments for women with mild to moderate hypertension during pregnancy .