by expert on call (297 Posts), Wed Aug 27, 2003 10:46 am
A 35 year old with easily controlled hypertension should have a successful pregnancy outcome statistically approaching the odds for normotensive women. However there is a 20-25% chance of developing superimposed preeclampsia. In most the complication will occur near term, but a few will experience severe disease and thus patients with essential hypertension should have their gestations managed by physicians who specialize in high risk obstetrics and preferably delivery at a tertiary center with a specialized nursery for very premature infants (for the very few who develop early superimposed preeclampsia).
Concerning anti-hypertensive therapy: The two recommended drugs with the largest reported experience of use in pregnant women are methyl dopa (aldomet) and labetalol (normodyne). The former is unique for a study that followed the newborn for 7.5 years. Many physicians prefer not to use pure beta blocking agents such as toprol, as such drugs are reported to be associated with smaller babies or even growth retardation. However at least one group takes an opposite opinion claiming beta blockers (particularly atenolol) reduces the incidence of preeclampsia.
In summary: the prognosis for the patient is good in the hands of a high risk specialist
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