A comparison of acebutolol with methyldopa in hypertensive pregnancy

Twenty pregnant women with mild to moderate hypertension were treated with either methyldopa or acebutolol, a beta-adrenergic blocking agent with cardioselectivity and intrinsic sympathomimetic activity, in a prospective open study. The two groups were comparable, although some selection bias may have been present. The dose of either drug was adjusted to attain a diastolic blood pressure of 80 mmHg or less, and 2 of the acebutolol group and 1 of the methyldopa group required the addition of hydralazine to achieve this. There were no still births or neo-natal deaths in either group. There was no difference discernible between the groups in duration of pregnancy, birth weight. Apgar score or placental weight, and no evidence of bradycardia, hypoglycaemia or respiratory difficulty in the babies born to mothers taking acebutolol. Fewer side-effects seemed to be present in the acebutolol group, and the mean period of hospitalization during pregnancy was 8 days in these patients compared with 14 days in the methyldopa group (p less than 0.01). The results of this pilot study suggest that acebutolol warrants further investigation as an effective and well-tolerated treatment of hypertension in pregnancy.