MANAGEMENT OF HYPERTENSIVE
DISORDERS IN PREGNANCY
- An evidence based approach
Dr. Mohammed Sadiq Azam M.D. (Int Med)
Senior Resident, Department of Medicine, Osmania General Hospital
Physician, Princess Esra Hospital
• Hypertensive disorders complicating pregnancy are one of the
major causes of maternal and foetal mortality and morbidity.
• Early diagnosis and management can help in circumventing many of
the complications of the same.
• Both labetolol and methydopa have been recommended as firstline drugs in various studies. Final use depends on a careful
assessment of risk benefit ratio and clinician judgement.
• Nifidipine sustained release should be used as a second line drug
and SUBLINGUAL NIFIDIPINE should NEVER be used.
• Watch for and screen for pre-ecclampsia in high risk individuals at regular
• Test of choice for proteinuria is an automated reagent strip reading device
or urinary spot protein:creatinine ratio.
• Aspirin is the ONLY PROVEN method of primary prevention of
hypertensive disorders in high risk individuals.
• Patient counselling and education regarding nature of illness and informed
consent prior to initiating treatment is mandatory.
• With early detection and appropriate management, the journey with
hypertension can be made a smooth one for both mother and child.
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