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Review

Pharmacotherapy for hypertension in pregnant patients: special considerations

, &
Pages 963-982 | Received 25 Jul 2018, Accepted 11 Mar 2019, Published online: 03 Apr 2019

References

  • American College of Obstetricians and Gynecologists. Task force on hypertension in pregnancy. Hypertension in pregnancy. Report of the American college of obstetricians and gynecologists’ task force on hypertension in pregnancy. Obstet Gynecol. 2013;122:1122–1131.
  • Lo JO, Mission JF, Caughey AB. Hypertensive disease of pregnancy and maternal mortality. Curr Opin Obstet Gynecol. 2013;25:124–132.
  • Leffert LR, Clancy CR, Bateman BT, et al. Hypertensive disorders and pregnancy-related stroke: frequency, trends, risk factors, and outcomes. Obstet Gynecol. 2015;125:124–131.
  • Vest AR, Cho LS. Hypertension in pregnancy. Curr Atheroscler Rep. 2014;16:395.
  • Bateman BT, Bansil P, Hernandez-Diaz S, et al. Prevalence, trends, and outcomes of chronic hypertension: a nationwide sample of delivery admissions. Am J Obstet Gynecol. 2012;206:e1–134.e8.
  • Say L, Chou D, Gemmill A, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2:e323–e333.
  • Lindheimer MD, Taler SJ, Cunningham FG. ASH position paper: hypertension in pregnancy. J Clin Hypertens (Greenwich). 2009;11:214–225.
  • Ananth CV, Keyes KM, Wapner RJ. Pre-eclampsia rates in the United States, 1980–2010: age-period-cohort analysis. BMJ. 2013;347:f6564.
  • Brown MC, Best KE, Pearce MS, et al. Cardiovascular disease risk in women with pre-eclampsia: systematic review and meta-analysis. Eur J Epidemiol. 2013;28:1–19.
  • Hutcheon JA, Lisonkova S, Joseph KS. Epidemiology of pre-eclampsia and the other hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol. 2011;25:391–403.
  • Ahmad AS, Samuelsen SO. Hypertensive disorders in pregnancy and fetal death at different gestational lengths: a population study of 2 121 371 pregnancies. BJOG. 2012;119:1521–1528.
  • Seely EW, Ecker J. Chronic hypertension in pregnancy. Circulation. 2014;129:1254–1261.
  • Sibai BM. Chronic hypertension in pregnancy. Obstet Gynecol. 2002;100:369–377.
  • Zhang J, Meikle S, Trumble A. Severe maternal morbidity associated with hypertensive disorders in pregnancy in the United States. Hypertens Pregnancy. 2003;22:203–212.
  • Bellamy L, Casas J-P, Hingorani AD, et al. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007;335:974.
  • Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. ESC guidelines for the management of cardiovascular diseases during pregnancy. Eur Heart J. 2018;2018(39):3165–3241.
  • van Oostwaard MF, Langenveld J, Schuit E, et al. Recurrence of hypertensive disorders of pregnancy: an individual patient data metaanalysis. Am J Obstet Gynecol. 2015;212:624.e1–624.17.
  • Zeitlin J, El AM, Jarreau PH, et al. Impact of foetal growth restriction on mortality and morbidity in a very preterm birth cohort. J Pediatr. 2010;157:733e9.
  • Habli M, Levine RJ, Qian C, et al. Neonatal outcomes in pregnancies with preeclampsia or gestational hypertension and in normotensive pregnancies that delivered at 35, 36, or 37 weeks of gestation. Am J Obstet Gynecol. 2007;197:406.e1–7.
  • Sibai BM, Stella CL. Diagnosis and management of atypical preeclampsia-eclampsia. Am J Obstet Gynecol. 2009;200:481.e1–481.e7.
  • Chappell LC, Enye S, Seed P, et al. Adverse perinatal outcomes and risk factors for preeclampsia in women with chronic hypertension: a prospective study. Hypertension. 2008;51:1002–1009.
  • Duley L. The Global Impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33:130–137.
  • Langenveld J, Ravelli ACJ, van Kaam AH, et al. Neonatal outcome of pregnancies complicated by hypertensive disorders between 34 and 37 weeks of gestation: a 7 year retrospective analysis of a national registry. Am J Obstet Gynecol. 2011;205:540.e1–7.
  • Behrens I, Basit S, Melbye M, et al. Risk of post-pregnancy hypertension in women with a history of hypertensive disorders of pregnancy: nationwide cohort study. BMJ. 2017;358:j3078.
  • Harmon QE, Huang L, Umbach DM, et al. Risk of fetal death with preeclampsia. Obstet Gynecol. 2015;125:628–635.
  • Black MH, Zhou H, Sacks DA, et al. Hypertensive disorders first identified in pregnancy increase risk for incident prehypertension and hypertension in the year after delivery. J Hypertens. 2016;34:728–735.
  • Grandi SM, Filion KB, Yoon S, et al. Cardiovascular disease-related morbidity and mortality in women with a history of pregnancy complications. Circulation. 2019;139:1069–1079.
  • Stuart JJ, Tanz LJ, Missmer SA, et al. Hypertensive disorders of pregnancy and maternal cardiovascular disease risk factor development: an observational cohort study. Ann Intern Med. 2018;169:224–232.
  • Wikström A-K, Haglund B, Olovsson M, et al. The risk of maternal ischaemic heart disease after gestational hypertensive disease. BJOG. 2005;112:1486–1491.
  • Ronsmans C, Graham WJ. Maternal mortality: who, when, where, and why. Lancet. 2006;368:1189–1200.
  • Lykke JA, Langhoff-Roos J, Sibai BM, et al. Hypertensive pregnancy disorders and subsequent cardiovascular morbidity and type 2 diabetes mellitus in the mother. Hypertension. 2009;53:944–951.
  • Magnussen EB, Vatten LJ, Smith GD, et al. Hypertensive disorders in pregnancy and subsequently measured cardiovascular risk factors. Obstet Gynecol. 2009;114:961–970.
  • Kajantie E, Eriksson JG, Osmond C, et al. Pre-eclampsia is associated with increased risk of stroke in the adult offspring: the Helsinki Birth Cohort Study. Stroke. 2009;40:1176–1180.
  • Theilen LH, Fraser A, Hollingshaus MS, et al. All-cause and cause-specific mortality after hypertensive disease of pregnancy. Obstet Gynecol. 2016;128:238–244.
  • Tooher J, Thornton C, Makris A, et al. Hypertension in pregnancy and long-term cardiovascular mortality: a retrospective cohort study. Am J Obstet Gynecol. 2016;214:722e1–e726.
  • Aukes AM, De Groot JC, Aarnoudse JG, et al. Brain lesions several years after eclampsia. Am J Obstet Gynecol. 2009;200:504e1–5.
  • Wiegman MJ, de Groot JC, Jansonius NM, et al. Long-term visual functioning after eclampsia. Obstet Gynecol. 2012;119:959–966.
  • Aukes AM, de Groot JC, Wiegman MJ, et al. Long-term cerebral imaging after preeclampsia. BJOG. 2012;119:1117–1122.
  • Robbins CL, Dietz PM, Bombard J, et al. Gestational hypertension: a neglected cardiovascular disease risk marker. Am J Obstet Gynecol. 2011;204:336.e1–9.
  • Romundstad PR, Magnussen EB, Smith GD, et al. Hypertension in pregnancy and later cardiovascular risk: common antecedents? Circulation. 2010;122:579–584.
  • National Institute for Health and Clinical Excellence. (CG107) hypertension in pregnancy: the management of hypertensive disorders during pregnancy. London: RCOG Press; 2011.
  • Magee LA, Pels A, Helewa M, et al. Canadian Hypertensive Disorders of Pregnancy Working Group. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obstet Gynaecol Can. 2014;36:416–441.
  • Lowe SA, Bowyer L, Lust K, et al. The SOMANZ guidelines for the management of hypertensive disorders of pregnancy 2014. Aust N Z J Obstet Gynaecol. 2015;55:e1–29.
  • Brown MA, Magee LA, Kenny LC, et al. International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertensive disorders of pregnancy: ISSHP classification, diagnosis, and management recommendations for international practice. Hypertension. 2018;72:24–43.
  • Buchbinder A, Sibai BM, Caritis S, et al. Adverse perinatal outcomes are significantly higher in severe gestational hypertension than in mild preeclampsia. Am J Obstet Gynecol. 2002;186:66–71.
  • Gulati M. Early identification of pregnant women at risk for preeclampsia: USPSTF recommendations on screening for preeclampsia. JAMA Cardio. 2017;2:593–595.
  • Bellomo G, Narducci PL, Rondoni F, et al. Prognostic value of 24-hour blood pressure in pregnancy. JAMA. 1999;282:1447–1452.
  • Bar J, Maymon R, Padoa A, et al. White coat hypertension and pregnancy outcome. J Hum Hypertens. 1999;13:541–545.
  • Rodrigues A, Barata C, Marques I, et al. Diagnosis of white coat hypertension and pregnancy outcomes. Pregnancy Hypertens. 2018;14:121–124.
  • Brown MA, Mangos G, Davis G, et al. The natural history of white coat hypertension during pregnancy. BJOG. 2005;112:601–606.
  • O’Brien E, Parati G, Stergiou G, et al. European society of hypertension working group on blood pressure monitoring. European society of hypertension position paper on ambulatory blood pressure monitoring. J Hypertens. 2013;31:1731–1768.
  • Williams B, Mancia G, Spiering W, et al. ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021–3104.
  • Banegas JR, Ruilope LM, de la Sierra A, et al. Relationship between clinic and ambulatory blood-pressure measurements and mortality. N Engl J Med. 2018;378:1509–1520.
  • Gofton EN, Capewell V, Natale R, et al. Obstetrical intervention rates and maternal and neonatal outcomes of women with gestational hypertension. Am J Obstet Gynecol. 2001;185:798–803.
  • Steer PJ, Little MP, Kold-Jensen T, et al. Maternal blood pressure in pregnancy, birth weight, and perinatal mortality in first births: prospective study. BMJ. 2004;329:1312.
  • Davis GK, Mackenzie C, Brown MA, et al. Predicting transformation from gestational hypertension to preeclampsia in clinical practice: a possible role for 24 hour ambulatory blood pressure monitoring. Hypertens Pregnancy. 2007;26:77–87.
  • Anumba DO, Lincoln K, Robson SC. Predictive value of clinical and laboratory indices at first assessment in women referred with suspected gestational hypertension. Hypertens Pregnancy. 2010;29:163–179.
  • Lee-Ann Hawkins T, Brown MA, Mangos GJ, et al. Transient gestational hypertension: not always a benign event. Pregnancy Hypertens. 2012;2:22–27.
  • Huppertz B. Placental origins of preeclampsia: challenging the current hypothesis. Hypertension. 2008;51:970–975.
  • Snydal S. Major changes in diagnosis and management of preeclampsia. J MidwiferyWomens Health. 2014;59:596–605.
  • August P, Malha L. Postpartum hypertension: “it ain’t over ‘til it’s over”. Circulation. 2015;132:1690–1692.
  • Firoz T, Magee LA, MacDonell K, et al. Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review. BJOG. 2014;121:1210–1218.
  • Clark SL, Belfort MA, Dildy GA, et al. Maternal death in the 21st century: causes, prevention, and relationship to cesarean delivery. Am J Obstet Gynecol. 2008;199:36.e1–5.
  • Martin JN Jr, Thigpen BD, Moore RC, et al. Stroke and severe preeclampsia and eclampsia: a paradigm shift focusing on systolic blood pressure. Obstet Gynecol. 2005;105:246–254.
  • Hofmeyr GJ, Lawrie TA, Atallah AN, et al. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2014 Jun 24;(6):CD001059. doi: 10.1002/14651858.CD001059.pub4
  • Bujold E, Roberge S, Lacasse Y, et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a metaanalysis. Obstet Gynecol. 2010;116:402–414.
  • WHO Recommendations for Prevention and Treatment of Pre-Eclampsia and Eclampsia. Geneva: World Health Organization; 2011. ISBN-13: 978-92-4-154833-5.
  • Sibai BM, Koch MA, Freire S, et al. The impact of prior preeclampsia on the risk of superimposed preeclampsia and other adverse pregnancy outcomes in patients with chronic hypertension. Am J Obstet Gynecol. 2011;204:345e1–345.e6.
  • Gilbert WM, Young AL, Danielsen B. Pregnancy outcomes in women with chronic hypertension: a population-based study. J Reprod Med. 2007;52:1046–1051.
  • Anderson GD, Carr DB. Effect of pregnancy on the pharmacokinetics of antihypertensive drugs. Clin Pharmacokinet. 2009;48:159–168.
  • Costantine MM. Physiologic and pharmacokinetic changes in pregnancy. Front Pharmacol. 2014;5:65.
  • Ke AB, Rostami-Hodjegan A, Zhao P, et al. Pharmacometrics in pregnancy: an unmet need. Annu Rev Pharmacol Toxicol. 2014;54:53–69.
  • Pieper PG. Use of medication for cardiovascular disease during pregnancy. Nat Rev Cardiol. 2015;12:718–729.
  • Robson SC, Hunter S, Boys RJ, et al. Serial study of factors influencing changes in cardiac output during human pregnancy. Am J Physiol. 1989;256:H1060–H1065.
  • Capeless EL, Clapp JF. Cardiovascular changes in early phase of pregnancy. Am J Obstet Gynecol. 1989;161:1449–1453.
  • Chapman AB, Abraham WT, Zamudio S, et al. Temporal relationships between hormonal and hemodynamic changes in early human pregnancy. Kidney Int. 1998;54:2056–2063.
  • Mahendru AA, Everett TR, Wilkinson IB, et al. Maternal cardiovascular changes from pre-pregnancy to very early pregnancy. J Hypertens. 2012;30:2168–2172.
  • Macedo ML, Luminoso D, Savvidou MD, et al. Maternal wave reflections and arterial stiffness in normal pregnancy as assessed by applanation tonometry. Hypertension. 2008;51:1047–1051.
  • Fujime M, Tomimatsu T, Okaue Y, et al. Central aortic blood pressure and augmentation index during normal pregnancy. Hypertens Res. 2012;35:633–638.
  • Yoder SR, Thornburg LL, Bisognano JD. Hypertension in pregnancy and women of childbearing age. Am J Med. 2009;122:890–895.
  • Easterling TR, Benedetti TJ, Carlson KC, et al. The effect of maternal hemodynamics on fetal growth in hypertensive pregnancies. Am J Obstet Gynecol. 1991;165:902–906.
  • Easterling TR. Pharmacological management of hypertension in pregnancy. Seminars Perinatol. 2014;38:487–495.
  • Rosano GM, Lewis B, Agewall S, et al. Gender differences in the effect of cardiovascular drugs: a position document of the working group on pharmacology and drug therapy of the ESC. Eur Heart J. 2015;36:2677–2680.
  • Haas DM, D’Alton M. Pharmacogenetics and other reasons why drugs can fail in pregnancy: higher dose or different drug? Obstet Gynecol. 2012;120:1176–1179.
  • Thorpe PG, Gilboa SM, Hernandez-Diaz S, et al. Medications in the first trimester of pregnancy: most common exposures and critical gaps in understanding fetal risk. Pharmacoepidemiol Drug Saf. 2013;22:1013–1101.
  • Orbach H, Matok I, Gorodischer R, et al. Hypertension and antihypertensive drugs in pregnancy and perinatal outcomes. Am J Obstet Gynecol. 2013;208:301–306.
  • Fitton CA, Steiner M, Aucott L, et al. In-utero exposure to antihypertensivemedication and neonatal and child health outcomes: a systematic review. J Hypertens. 2017;35:2123–2137.
  • Magee LA, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2003;3:CD002863.
  • Nakhai-Pour HR, Rey E, Berard A. Antihypertensive medication use during pregnancy and the risk of major congenital malformations or small-for-gestational-age newborns. Birth Defects Res B Dev Reprod Toxicol. 2010;89:147–154.
  • Davis RL, Eastman D, McPhillips H, et al. Risks of congenital malformations and perinatal events among infants exposed to calcium channel and beta-blockers during pregnancy. Pharmacoepidemiol Drug Saf. 2011;20:138–145.
  • Molvi SN, Mir S, Rana VS, et al. Role of antihypertensive therapy in mild to moderate pregnancy-induced hypertension: a prospective randomized study comparing labetalol with alpha methyldopa. Arch Gynecol Obstet. 2012;285:1553–1562.
  • Yakoob MY, Bateman BT, Ho E, et al. The risk of congenital malformations associated with exposure to beta-blockers early in pregnancy: a meta-analysis. Hypertension. 2013;62:375–381.
  • Al Khaja KA, Sequeira RP, Alkhaja AK, et al. Drug treatment of hypertension in pregnancy: a critical review of adult guideline recommendations. J Hypertens. 2014;32:454–463.
  • Magee LA, Schick B, Donnenfeld AE, et al. The safety of calcium channel blockers in human pregnancy: a prospective, multicenter cohort study. Am J Obstet Gynecol. 1996;174:823–828.
  • Weber-Schoendorfer C, Hannemann D, Meister R, et al. The safety of calcium channel blockers during pregnancy: a prospective, multicenter, observational study. Reprod Toxicol. 2008;26:24–30.
  • Cockburn J, Moar VA, Ounsted M, et al. Final report of study on hypertension during pregnancy: the effects of specific treatment on the growth and development of the children. Lancet. 1982;1:647–649
  • el-Qarmalawi AM, Morsy AH, al-Fadly A, et al. Labetalol vs. methyldopa in the treatment of pregnancy-induced hypertension. Int J Gynaecol Obstet. 1995;49:125–130.
  • Fidler J, Smith V, Fayers P, et al. Randomized controlled comparative study of methyldopa and oxprenolol in treatment of hypertension in pregnancy. BMJ. 1983;286:1927–1930.
  • Lupattelli A, Spigset O, Nordeng H. Adherence to medication for chronic disorders during pregnancy: results from a multinational study. Int J Clin Pharm. 2014;36:145–153.
  • Caton AR, Bell EM, Druschel CM, et al. National birth defects prevention study. Antihypertensive medication use during pregnancy and the risk of cardiovascular malformations. Hypertension. 2009;54:63–70.
  • Lennestal R, Otterblad OP, Kallen B. Maternal use of antihypertensive drugs in early pregnancy and delivery outcome, notably the presence of congenital heart defects in the infants. Eur J Clin Pharmacol. 2009;65:615–625.
  • Caton AR, Bell EM, Druschel CM, et al. National birth defects prevention study. Maternal hypertension, antihypertensive medication use, and the risk of severe hypospadias. Birth Defects Res A Clin Mol Teratol. 2008;82:34–40.
  • Tabacova S, Little R, Tsong Y, et al. Adverse pregnancy outcomes associated with maternal enalapril antihypertensive treatment. Pharmacoepidemiol Drug Saf. 2003;12:633–646.
  • Cooper WO, Hernandez-Diaz S, Arbogast PG, et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med. 2006;354:2443–2451.
  • Quan A. Fetopathy associated with exposure to angiotensin converting enzyme inhibitors and angiotensin receptor antagonists. Early Human Dev. 2006;82:23–28.
  • Moretti ME, Caprara D, Drehuta I, et al. The fetal safety of angiotensin converting enzyme inhibitors and angiotensin II receptor blockers. Obstet Gynecol Int. 2012;2012:658310.
  • Pucci M, Sarween N, Knox E, et al. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in women of childbearing age: risks versus benefits. Expert Rev Clin Pharmacol. 2015;8:221–231.
  • Ruys TP, Maggioni A, Johnson MR, et al. Cardiac medication during pregnancy, data from the ROPAC. Int J Cardiol. 2014;177:124–128.
  • Hecker A, Hasan SH, Neumann F. Disturbances in sexual differentiation of rat fetuses following spironolactone treatment. Acta Enodcrinol (Copenh). 1980;95:540–545.
  • Groves TD, Corenblum B. Spironolactone therapy during human pregnancy. Am J Obstet Gynecol. 1995;172:1655–1656.
  • Lydakis C, Lip G, Beevers M, et al. Atenolol and fetal growth in pregnancies complicated by hypertension. Am J Hypertens. 1999;12:541–547.
  • Reynolds B, Butters L, Evans J, et al. First year of life after the use of atenolol in pregnancy associated hypertension. Arch Dis Child. 1984;59:1061–1063.
  • Butters L, Kennedy S, Rubin PC. Atenolol in essential hypertension during pregnancy. BMJ. 1990;301:587–859.
  • Committee on Obstetric Practice. Emergent therapy for acuteonset, severe hypertension during pregnancy and the postpartum period. Committee Opinion No. 623. American college of obstetricians and gynecologists. Obstet Gynecol. 2015;125:521–525.
  • Collins R, Yusuf S, Peto R. Overview of randomized trials of diuretics in pregnancy. BMJ. 1985;290:17–23.
  • Churchill D, Beevers GDG, Meher S, et al. Diuretics for preventing pre-eclampsia. Cochrane Database Syst Rev. 2007;(1):CD004451. doi: 10.1002/14651858.CD004451.pub2
  • Briggs G, Freeman R, Yaffe S. Drugs in pregnancy and lactation: reference guide to fetal and neonatal risk. Philadelphia: Lippincott Williams and Wilkins; 2002.
  • Ferrer RL, Sibai BM, Mulrow CD, et al. Management of mild chronic hypertension during pregnancy: a review. Obstet Gynecol. 2000;96:849–860.
  • Beardmore KS, Morris JM, Gallery ED Excretion of antihypertensive medication into human breast milk: a systematic review. Hypertens Pregnancy. 2002;21:85–95.
  • Sibai B, Grossman RA, Grossman HG. Effects of diuretics on plasma volume in pregnancies with long-term hypertension. Am J Obstet Gynecol. 1984;150:831–835.
  • American Academy of Pediatrics. Committee on Drugs. The transfer of drugs and other chemicals into human milk. Pediatrics. 2001;108:776–789.
  • Williams B, Poulter NR, Brown MJ, et al. Society. Guidelines for management of hypertension: report of the fourth working party of the british hypertension society, – BHS IV. J Hum Hypertens. 2004;18:139–185.
  • Magee L. Treating hypertension in women of child-bearing age and during pregnancy. Drug Saf. 2001;24:457–474.
  • von Dadelszen P, Magee LA. Fall in mean arterial pressure and fetal growth restriction in pregnancy hypertension: an updated meta-regression analysis. J Obstet Gynaecol Can. 2002;24:941–945.
  • Meidahl Petersen K, Jimenez-Solem E, Andersen JT, et al. β-Blocker treatment during pregnancy and adverse pregnancy outcomes: a nationwide population-based cohort study. BMJ Open. 2002 Jul 19;2(4). pii: e001185. doi: 10.1136/bmjopen-2012-001185
  • von Dadelszen P, Ornstein MP, Bull SB, et al. Fall in mean arterial pressure and fetal growth restriction in pregnancy hypertension: a meta-analysis. Lancet. 2000;355:87–92.
  • Magee LA, Elran E, Bull SB, et al. Risks and benefits of beta-receptor blockers for pregnancy hypertension: overview of the randomized trials. Eur J Obstet Gynecol Reprod Biol. 2000;88:15–26.
  • Magee LA, Ornstein MP, von Dadelszen P. Fortnightly review: management of hypertension in pregnancy. BMJ. 1999;318:1332–1336.
  • Ersbøll AS, Hedegaard M, Søndergaard L, et al. Treatment with oral beta-blockers during pregnancy complicated by maternal heart disease increases the risk of fetal growth restriction. BJOG. 2014;121(5):618–626.
  • Klarr JM, Bhatt-Mehta V, Donn SM. Neonatal adrenergic blockade following single dose maternal labetalol administration. Am J Perinatol. 1994;11:91–93.
  • Bateman BT, Patorno E, Desai RJ, et al. Late pregnancy β blocker exposure and risks of neonatal hypoglycemia and bradycardia. Pediatrics. 2016;138:e20160731.
  • Gelson E, Curry R, Gatzoulis MA, et al. Effect of maternal heart disease on fetal growth. Obstet Gynecol. 2011;117:886–891.
  • Prefumo F, Sebire NJ, Thilaganathan B. Decreased endovascular trophoblast invasion in first trimester pregnancies with high-resistance uterine artery Doppler indices. Hum Reprod. 2004;19:206–209.
  • Osol G, Mandala M. Maternal uterine vascular remodeling during pregnancy. Physiology (Bethesda). 2009;24:58–71.
  • Kramer MS, Platt R, Yang H, et al. Are all growth-restricted newborns created equal(ly). Pediatrics. 1999;103:599–602.
  • Nakhai-Pour HR, Rey E, Bérard A. Discontinuation of antihypertensive drug use during pregnancy and the risk of pre-eclampsia and eclampsia among women with chronic hypertension. Am J Obstet Gynecol. 2009;180:e1–8.
  • Cleary KL, Siddiq Z, Ananth CV, et al. Use of antihypertensive medications during delivery hospitalizations complicated by preeclampsia. Obstet Gynecol. 2018;131:441–450.
  • Whelton PK, Carey RM, Aronow WS, et al. ACC/-AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American college of cardiology/American Heart Association task force on clinical practice guidelines. J Am Coll Cardiol. 2017;2018(71):e127–248.
  • Duley L, Meher S, Jones L. Drugs for treatment of very high blood pressure during pregnancy. Cochrane Database Syst Rev. 2013;(7):CD001449. doi: 10.1002/14651858.CD001449.pub3
  • Podymow T, August P. Update on the use of antihypertensive drugs in pregnancy. Hypertension. 2008;51:960–969.
  • Abalos E, Duley L, Steyn DW, et al. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2018;(10):CD002252. doi: 10.1002/14651858.CD002252.pub4
  • von Dadelszen P, Menzies JM, Payne B, et al. Predicting adverse outcomes in women with severe preeclampsia. Semin Perinatol. 2011;33:152–157.
  • Nabhan AF, Elsedawy MM. Tight control of mild-moderate pre-existing or non-proteinuric gestational hypertension. Cochrane Database Syst Rev. 2011;(7):CD006907. doi: 10.1002/14651858.CD006907.pub2
  • Magee LA, von Dadelszen P, Rey E, et al. Less-tight versus tight control of hypertension in pregnancy. N Engl J Med. 2015;372:407–417.
  • Magee LA, von Dadelszen P, Singer J, et al. The CHIPS randomized controlled trial (control of hypertension in pregnancy study): is severe hypertension just an elevated blood pressure? Hypertension. 2016;68:1153–1159.
  • Committee on Obstetric Practice. Committee opinion No. 767: emergent therapy for acute-onset, severe hypertension during pregnancy and the postpartum period. Obstet Gynecol. 2019;133:e174–e180.
  • Cantwell R, Clutton-Brock T, Cooper G, et al. Saving Mothers’ Lives: reviewing maternal deaths to make motherhood safer: 2006–2008. The eighth report of the confidential enquiries into maternal deaths in the United Kingdom. BJOG. 2011;118((suppl1)):1–203.
  • Bernstein PS, Martin JN, Barton JR Jr, et al. Consensus bundle on severe hypertension during pregnancy and the postpartum period. J MidwiferyWomens Health. 2017;62:493–501.
  • Cipolla MJ. Cerebrovascular function in pregnancy and eclampsia. Hypertension. 2007;50:14–24.
  • van Veen TR, Panerai RB, Haeri S, et al. Cerebral autoregulation in normal pregnancy and preeclampsia. Obstet Gynecol. 2013;122:1064–1069.
  • Schutte JM, Schuitemaker NEW, van Roosmalen J, et al. Dutch maternal mortality committee. Substandard care in maternal mortality due to hypertensive disease in pregnancy in the Netherlands. BJOG. 2008;115:732–736.
  • Scott CA, Bewley S, Rudd A, et al. Incidence, risk factors, management, and outcomes of stroke in pregnancy. Obstet Gynecol. 2012;120:318–324.
  • Foo L, Tay J, Lees CC, et al. Hypertension in pregnancy: natural history and treatment options. Curr Hypertens Rep. 2015;17:36.
  • Practice Bulletin ACOG. Clinical management guidelines for obstetrician-gynecologist, number 202. gestational hypertension and preeclampsia. Obstet Gynecol. 2019;133:e1–e25.
  • Altman D, Carroli G, Duley L, et al. Magpie Trial Collaboration Group. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The magpie trial: a randomised placebo-controlled trial. Lancet. 2002;359:1877–1890.
  • Livingston JC, Livingston LW, Ramsey R, et al. Magnesium sulfate in women with mild preeclampsia: a randomized controlled trial. Obstet Gynecol. 2003;101:217–220.
  • Vermillion ST, Scardo JA, Newman RB, et al. A randomized, double-blind trial of oral nifedipine and intravenous labetalol in hypertensive emergencies of pregnancy. Am J Obstet Gynecol. 1999;181:858–861.
  • Vigil-De Gracia P, Ruiz E, Lopez JC, et al. Management of severe hypertension in the postpartum period with intravenous hydralazine or labetalol: a randomized clinical trial. Hypertens Preg. 2007;26:163–171.
  • Raheem IA, Saaid R, Omar SZ, et al. Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomised trial. BJOG. 2012;119:78–85.
  • Moretti MM, Fairlie FM, Akl S, et al. The effect of nifedipine therapy on fetal and placental Doppler waveforms in preeclampsia remote from term. Am J Obstet Gynecol. 1990;163:1844–1848.
  • Scardo JA, Vermillion ST, Hogg BB, et al. Hemodynamic effects of oral nifedipine in preeclamptic hypertensive emergencies. Am J Obstet Gynecol. 1996;175:336–338.
  • Baggio MR, Martins WP, Calderon AC, et al. Changes in fetal and maternal Doppler parameters observed during acute severe hypertension treatment with hydralazine or labetalol: a randomized controlled trial. Ultrasound Med Biol. 2011;37:53–58.
  • Tuffnell DJ, Jankowicz D, Lindow SW, et al. Outcomes of severe pre-eclampsia/eclampsia in Yorkshire 1999/2003. Yorkshire obstetric critical care group. BJOG. 2005;112:875–880.
  • Sridharan K, Sequeira RP. Drugs for treating severe hypertension in pregnancy: a network meta-analysis and trial sequential analysis of randomized clinical trials. Br J Cin Pharmacol. 2018;84:1906–1916.
  • Impey L. Severe hypotension and fetal distress following sublingual administration of nifedipine to a patient with severe pregnancy induced hypertension at 33 weeks. Br J Obstet Gynaecol. 1993;100:959–961.
  • Papatsonis DN, Lok CA, Bos JM, et al. Calcium channel blockers in themanagement of preterm labor and hypertension in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2001;97:122–140.
  • Brown MA, Buddle ML, Farrell T, et al. Efficacy and safety of nifedipine tablets for the acute treatment of severe hypertension in pregnancy. Am J Obstet Gynecol. 2002;187:1046–1050.
  • Rezaei Z, Sharbaf FR, Pourmojieb M, et al. Comparison of the efficacy of nifedipine and hydralazine in hypertensive crisis in pregnancy. Acta Med Iran. 2011;49:701–706.
  • Martins Costa S, Ramos JG, Barros E, et al. Randomized, controlled trial of hydralazine versos nifedipine in preeclamptic women with acute hypertension. Clin Exp Hypertens B. 1992;11:25–44.
  • Sørensen HT, Steffensen FH, Olesen C, et al. Pregnancy outcome in women exposed to calcium channel blockers. Reprod Toxicol. 1998;12:383–384.
  • Gruppo di Studio Ipertensione in Gravidanza. Nifedipine versus expectant management in mild to moderate hypertension in pregnancy. Br J Obstet Gynaecol. 1998;105:718–722.
  • Hubinont C, Debieve F. Prevention of preterm labour: 2011 update on tocolysis. J Pregnancy. 2011;2011:941057.
  • Waisman GD, Mayorga LM, Camera MI, et al. Magnesium plus nifedipine: potentiation of hypotensive effect in preeclampsia? Am J Obstet Gynecol. 1988;159:308–309.
  • Snyder SW, Cardwell MS. Neuromuscular blockade with magnesium sulfate and nifedipine. Am J Obstet Gynecol. 1989;161:35–36.
  • Koontz SL, Friedman SA, Schwartz ML. Symptomatic hypocalcemia after tocolytic therapy with magnesium sulfate and nifedipine. Am J Obstet Gynecol. 2004;190:1773–1776.
  • Magee LA, Miremadi S, Li J, et al. Therapy with both magnesium sulfate and nifedipine does not increase the risk of serious magnesium-related maternal side effects in women with preeclampsia. Am J Obstet Gynecol. 2005;193:153–163.
  • Sibai BM, Mabie WC, Shamsa F, et al. A comparison of no medication versus methyldopa or labetalol in chronic hypertension during pregnancy. Am J Obstet Gynecol. 1990;162:960–967.
  • Vigil-De Gracia P, Lasso M, Ruiz E, et al. Severe hypertension in pregnancy: hydralazine or labetalol. A randomized clinical trial. Eur J Obstet Gynecol Reprod Biol. 2006;128:157–162.
  • Garden A, Davey DA, Dommisse J. Intravenous labetalol and intravenous dihydralazine in severe hypertension in regnancy. Clin Exp Hypertens B. 1982;1:371–383.
  • Chan WS, Koren G, Barrera M, et al. Neurocognitive development of children following in-utero exposure to labetalol for maternal hypertension: a cohort study using a prospectively collected database. Hypertens Pregnancy. 2010;29:271–283.
  • Pasker-De Jong PC, Zielhuis GA, van Gelder MM, et al. Antihypertensive treatment during pregnancy and functional development at primary school age in a historical cohort study. BJOG. 2010;117:1080–1086.
  • Sandström B. Antihypertensive treatment with the adrenergic betareceptor blocker metoprolol during pregnancy. Gynecol Invest. 1978;9:195–204.
  • Mesquita MRDS, Atallah AN, Rocha NDSC, et al. The use of hydralazine and nifedipine in hypertensive emergencies in pregnancy. Rev Bras Ginecol Obstet. 1995;17:103–111.
  • Moroz LA, Simpson LL, Rochelson B. Management of severe hypertension in pregnancy. Semin Perinatol. 2016;40:112–118.
  • Montan S, Anandakumar C, Arulkumaran S, et al. Effects of methyldopa on uteroplacental and fetal hemodynamics in pregnancy-induced hypertension. Am J Obstet Gynecol. 1993;168:152–156.
  • Magee LA, CHIPS Study Group, von Dadelszen P, et al. Do labetalol and methyldopa have different effects on pregnancy outcome? Analysis of data from the control of hypertension in pregnancy study (CHIPS) trial. BJOG. 2016;123:1143–1151.
  • Sass N, Itamoto CH, Silva MP, et al. Does sodium nitroprusside kill babies? A systematic review. Sao Paulo Med J. 2007;125:108–111.
  • Neri I, Valensise H, Facchinetti F, et al. 24-hour ambulatory blood pressure monitoring: a comparison between transdermal glyceryl-trinitrate and oral nifedipine. Hypertens Pregnancy. 1999;18:107–113.
  • Cetin A, Yurtcu N, Guvenal T, et al. The effect of glyceryl trinitrate on hypertension in women with severe preeclampsia, HELLP syndrome, and eclampsia. Hypertens Pregnancy. 2004;23:37–46.
  • Hernandez-Sierra JF, Rodriguez-Martinez M. Efficacy of nitroglycerine infusion versus sublingual nifedipine in severe preeclampsia: a randomized, triple-blind, controlled trial. Clin Exp Pharmacol Physiol. 2008;35:580–585.
  • Samadi AR, Mayberry RM, Zaidi AA, et al. Maternal hypertension and associated pregnancy complications among African-American and other women in the United States. Obstet Gynecol. 1996;87:557–563.
  • Healy AJ, Malone FD, Sullivan LM, et al. Early access to prenatal care: implications for racial disparity in perinatal mortality. Obstet Gynecol. 2006;107:625–631.
  • Whelton PK, Einhorn PT, Muntner P, et al. Research needs to improve hypertension treatment and control in African Americans. Hypertension. 2016;68:1066–1072.
  • Modesti PA, Reboldi G, Cappuccio FP, et al. Panethnic differences in blood pressure in Europe: a systematic review and meta-analysis. PLoS One. 2016;11:e0147601.
  • Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183:S1–S22.
  • Bramham K, Nelson-Piercy C, Brown MJ, et al. Postpartum management of hypertension. BMJ. 2013;346:f894.
  • Goel A, Maski MR, Bajracharya S, et al. Epidemiology and mechanisms of De Novo and persistent hypertension in the postpartum period. Circulation. 2015;132:1726–1733.
  • Cairns AE, Pealing L, Duffy JMN, et al. Postpartum management of hypertensive disorders of pregnancy: a systematic review. BMJ Open. 2017;7:e018696.
  • Magee L, von Dadelszen P. Prevention and treatment of postpartum hypertension. Cochrane Database Syst Rev. 2013;(4):CD004351. doi: 10.1002/14651858.CD004351.pub3
  • Makris A, Thornton C, Hennessy A. Postpartum hypertension and nonsteroidal analgesia. Am J Obstet Gynecol. 2004;190:577–578.
  • Snowden S, Nelson R. The effects of nonsteroidal antiinflammatory drugs on blood pressure in hypertensive patients. Cardiol Rev. 2011;19:184–191.
  • Wasden SW, Ragsdale ES, Chasen ST, et al. Impact of non-steroidal anti-inflammatory drugs on hypertensive disorders of pregnancy. Pregnancy Hypertens. 2014;4:259–263.
  • Viteri OA, England JA, Alrais MA, et al. Association of nonsteroidal antiinflammatory drugs and postpartum hypertension in women with preeclampsia with severe features. Obstet Gynecol. 2017;130:830–835.
  • Blue NR, Murray-Krezan C, Drake-Lavelle S, et al. Effect of ibuprofen vs acetaminophen on postpartum hypertension in preeclampsia with severe features: a double-masked, randomized controlled trial. Am J Obstet Gynecol. 2018;218:616.e1–8.

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