Mohamed Salama1, Mohamed Rezk2, Wael Gaber1, Haitham Hamza1, Hala Marawan3, Awni Gamal4, Sameh Abdallah5. 1. Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt. 2. Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt. Electronic address: m_rezk9207@med.menofia.edu.eg. 3. Department of Community Medicine and Public Health, Faculty of Medicine, Menoufia University, Egypt. 4. Department of Cardiology, Faculty of Medicine, Menoufia University, Egypt. 5. Department of Pediatrics, Faculty of Medicine, Menoufia University, Egypt.
Abstract
OBJECTIVE: To assess the maternal and fetal outcome in women with mild to moderate chronic hypertension on antihypertensive drug (methyldopa or nifedipine) therapy compared to no medication. METHODS: This multicenter randomized clinical trial was conducted at Menoufia University hospital, Shibin El-kom Teaching hospital and 11 Central hospitals at Menoufia governorate, Egypt.490 pregnant women with mild to moderate chronic hypertension were randomized into three groups; methyldopa group (n = 166), nifedipine group (n = 160) and control or no medication group (n = 164) who were followed from the beginning of pregnancy till the end of puerperium to record maternal and fetal outcome. RESULTS: Mothers in the control (no medication) group were more prone for the development of severe hypertension, preeclampsia, renal impairment, ECG changes, placental abruption and repeated hospital admissions (p < 0.001) when compared to mothers in both treatment groups (methyldopa and nifedipine). Neonates in the control (no medication) group were more prone for prematurity and admission to neonatal ICU (p < 0.001). CONCLUSION: Antihypertensive drug therapy is advisable in mild to moderate chronic hypertension during pregnancy to decrease maternal and fetal morbidity. When considering which agents to use for treatment, oral methyldopa and nifedipine are valid options.
OBJECTIVE: To assess the maternal and fetal outcome in women with mild to moderate chronic hypertension on antihypertensive drug (methyldopa or nifedipine) therapy compared to no medication. METHODS: This multicenter randomized clinical trial was conducted at Menoufia University hospital, Shibin El-kom Teaching hospital and 11 Central hospitals at Menoufia governorate, Egypt.490 pregnant women with mild to moderate chronic hypertension were randomized into three groups; methyldopa group (n = 166), nifedipine group (n = 160) and control or no medication group (n = 164) who were followed from the beginning of pregnancy till the end of puerperium to record maternal and fetal outcome. RESULTS: Mothers in the control (no medication) group were more prone for the development of severe hypertension, preeclampsia, renal impairment, ECG changes, placental abruption and repeated hospital admissions (p < 0.001) when compared to mothers in both treatment groups (methyldopa and nifedipine). Neonates in the control (no medication) group were more prone for prematurity and admission to neonatal ICU (p < 0.001). CONCLUSION: Antihypertensive drug therapy is advisable in mild to moderate chronic hypertension during pregnancy to decrease maternal and fetal morbidity. When considering which agents to use for treatment, oral methyldopa and nifedipine are valid options.
Authors: Jeffrey N Bone; Akshdeep Sandhu; Edgardo D Abalos; Asma Khalil; Joel Singer; Sarina Prasad; Shazmeen Omar; Marianne Vidler; Peter von Dadelszen; Laura A Magee Journal: Hypertension Date: 2022-01-04 Impact factor: 9.897