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Treatment and Prevention of Hypertensive Disorders During Pregnancy
Karla Leavitt1, Sarah Običan1, Jerome Yankowitz1
1Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of South Florida, Morsani College of Medicine, 2 Tampa General Circle, 6th Floor, Tampa, FL 33606, USA.
Abstract:
This article reviews the pharmacology of the most commonly used antihypertensive medications during pregnancy; their mechanism of action; and the effects on the mother, the fetus, and lactation. Each class of antihypertensive pharmacologic agents have specific mechanisms of action by which they exert their antihypertensive effect. β-Adrenoreceptor antagonists block these receptors in the peripheral circulation. Calcium channel blockers result in arterial vasodilation. α-Agonists inhibit vasoconstriction. Methyldopa is a centrally acting adrenoreceptor antagonist. Vasodilators have a direct effect on vascular smooth muscle. Diuretics decrease intravascular volume. Medications acting on the angiotensin pathway are avoided during pregnancy because of fetotoxic effects.
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