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Methyldopa versus nifedipine or no medication for treatment of chronic hypertension during pregnancy: A multicenter randomized clinical trial.
Pregnancy Hypertens. 2019 Jul; 17:54-58.PH

Abstract

OBJECTIVE

To assess the maternal and fetal outcome in women with mild to moderate chronic hypertension on antihypertensive drug (methyldopa or nifedipine) therapy compared to no medication.

METHODS

This multicenter randomized clinical trial was conducted at Menoufia University hospital, Shibin El-kom Teaching hospital and 11 Central hospitals at Menoufia governorate, Egypt.490 pregnant women with mild to moderate chronic hypertension were randomized into three groups; methyldopa group (n = 166), nifedipine group (n = 160) and control or no medication group (n = 164) who were followed from the beginning of pregnancy till the end of puerperium to record maternal and fetal outcome.

RESULTS

Mothers in the control (no medication) group were more prone for the development of severe hypertension, preeclampsia, renal impairment, ECG changes, placental abruption and repeated hospital admissions (p < 0.001) when compared to mothers in both treatment groups (methyldopa and nifedipine). Neonates in the control (no medication) group were more prone for prematurity and admission to neonatal ICU (p < 0.001).

CONCLUSION

Antihypertensive drug therapy is advisable in mild to moderate chronic hypertension during pregnancy to decrease maternal and fetal morbidity. When considering which agents to use for treatment, oral methyldopa and nifedipine are valid options.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Salama M
Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt.
Rezk M
Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt. Electronic address: m_rezk9207@med.menofia.edu.eg.
Gaber W
Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt.
Hamza H
Department of Obstetrics and Gynecology, Faculty of Medicine, Menoufia University, Egypt.
Marawan H
Department of Community Medicine and Public Health, Faculty of Medicine, Menoufia University, Egypt.
Gamal A
Department of Cardiology, Faculty of Medicine, Menoufia University, Egypt.
Abdallah S
Department of Pediatrics, Faculty of Medicine, Menoufia University, Egypt.

MeSH

Administration, OralAdultAntihypertensive AgentsEgyptFemaleHumansHypertensionHypertension, Pregnancy-InducedInfant, NewbornMethyldopaNifedipinePregnancyPregnancy Complications, CardiovascularPrenatal DiagnosisTreatment OutcomeYoung Adult

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

31487657

Citation

Salama, Mohamed, et al. "Methyldopa Versus Nifedipine or No Medication for Treatment of Chronic Hypertension During Pregnancy: a Multicenter Randomized Clinical Trial." Pregnancy Hypertension, vol. 17, 2019, pp. 54-58.
Salama M, Rezk M, Gaber W, et al. Methyldopa versus nifedipine or no medication for treatment of chronic hypertension during pregnancy: A multicenter randomized clinical trial. Pregnancy Hypertens. 2019;17:54-58.
Salama, M., Rezk, M., Gaber, W., Hamza, H., Marawan, H., Gamal, A., & Abdallah, S. (2019). Methyldopa versus nifedipine or no medication for treatment of chronic hypertension during pregnancy: A multicenter randomized clinical trial. Pregnancy Hypertension, 17, 54-58. https://doi.org/10.1016/j.preghy.2019.05.009
Salama M, et al. Methyldopa Versus Nifedipine or No Medication for Treatment of Chronic Hypertension During Pregnancy: a Multicenter Randomized Clinical Trial. Pregnancy Hypertens. 2019;17:54-58. PubMed PMID: 31487657.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Methyldopa versus nifedipine or no medication for treatment of chronic hypertension during pregnancy: A multicenter randomized clinical trial. AU - Salama,Mohamed, AU - Rezk,Mohamed, AU - Gaber,Wael, AU - Hamza,Haitham, AU - Marawan,Hala, AU - Gamal,Awni, AU - Abdallah,Sameh, Y1 - 2019/05/09/ PY - 2019/02/11/received PY - 2019/03/27/revised PY - 2019/05/08/accepted PY - 2019/9/6/pubmed PY - 2020/2/20/medline PY - 2019/9/6/entrez KW - Chronic hypertension KW - Fetal outcome KW - Maternal outcome KW - Methyldopa KW - Nifedipine SP - 54 EP - 58 JF - Pregnancy hypertension JO - Pregnancy Hypertens VL - 17 N2 - OBJECTIVE: To assess the maternal and fetal outcome in women with mild to moderate chronic hypertension on antihypertensive drug (methyldopa or nifedipine) therapy compared to no medication. METHODS: This multicenter randomized clinical trial was conducted at Menoufia University hospital, Shibin El-kom Teaching hospital and 11 Central hospitals at Menoufia governorate, Egypt.490 pregnant women with mild to moderate chronic hypertension were randomized into three groups; methyldopa group (n = 166), nifedipine group (n = 160) and control or no medication group (n = 164) who were followed from the beginning of pregnancy till the end of puerperium to record maternal and fetal outcome. RESULTS: Mothers in the control (no medication) group were more prone for the development of severe hypertension, preeclampsia, renal impairment, ECG changes, placental abruption and repeated hospital admissions (p < 0.001) when compared to mothers in both treatment groups (methyldopa and nifedipine). Neonates in the control (no medication) group were more prone for prematurity and admission to neonatal ICU (p < 0.001). CONCLUSION: Antihypertensive drug therapy is advisable in mild to moderate chronic hypertension during pregnancy to decrease maternal and fetal morbidity. When considering which agents to use for treatment, oral methyldopa and nifedipine are valid options. SN - 2210-7797 UR - https://www.unboundmedicine.com/medline/citation/31487657/Methyldopa_versus_nifedipine_or_no_medication_for_treatment_of_chronic_hypertension_during_pregnancy:_A_multicenter_randomized_clinical_trial_ DB - PRIME DP - Unbound Medicine ER -