Sotalol as a hypotensive agent in pregnancy

Area of Science:

• Pharmacology
• Obstetrics
• Neonatology

Background:

• Hypertension in pregnancy poses risks to both mother and fetus.
• Beta-adrenoceptor antagonists are commonly used to manage hypertension.
• Sotalol's safety and efficacy in pregnancy require further investigation.

Purpose of the Study:

• To evaluate the efficacy of sotalol in treating hypertension during pregnancy.
• To assess the placental transfer and breast milk excretion of sotalol.
• To determine the neonatal outcomes in infants exposed to sotalol in utero and via lactation.

Main Methods:

• Twelve hypertensive pregnant women received sotalol.
• Maternal plasma, amniotic fluid, umbilical cord plasma, and breast milk samples were analyzed for sotalol concentration.
• Neonatal outcomes and birth weights were recorded.

Main Results:

• Sotalol effectively reduced blood pressure at a mean dose of 433.1 mg/day.
• Sotalol readily crossed the placental barrier (maternal:fetal ratio 1:1.05).
• High concentrations of sotalol were found in breast milk (plasma:milk ratio 1:5.4).

Conclusions:

• Sotalol controls hypertension in pregnancy but crosses the placenta.
• High levels in breast milk suggest potential neonatal pharmacological effects.
• Sotalol offers no clear advantage over other beta-blockers in pregnancy due to placental transfer.