[Pros and cons in the therapy of hypertensive gestoses. II. Chronic hypertension]

The authors discuss some controversial aspects of the therapy of chronic hypertension in pregnancy. In cases in whom the blood pressure has been treated before conception the therapy should be continued. But there is no agreement about beginning of the hypotensive therapy during pregnancy. Some authors recommend an early treatment, others give hypotensive drugs only for those women who show no fall of the blood pressure in the second trimester or when the blood pressure exceeds 170/110 mm. Hg. These controversial opinions result from our defective notice of the uteroplacental blood flow during a long-continued application of antihypertensive drugs and their dose-response. As hypotensive agents methyldopa, hydralazine and beta adrenergic substances are recommended, on part of internists also medicaments which are used in nonpregnant patients. In severe chronic hypertension premature induction of labor is necessary. In hypertension III degree and IV degree the pregnancy should be interrupted.