open access

Vol 90, No 4 (2019)
ORIGINAL PAPERS Obstetrics
Published online: 2019-04-29
Get Citation

Rational control of arterial pressure during labor in women with arterial hypertension

Iryna Yevhenivna Humenna, Svitlana Nikolayivna Heryak, Victoryya Yuriyivna Dobryanska
DOI: 10.5603/GP.2019.0037
·
Pubmed: 31059113
·
Ginekol Pol 2019;90(4):206-211.

open access

Vol 90, No 4 (2019)
ORIGINAL PAPERS Obstetrics
Published online: 2019-04-29

Abstract

Objectives: Were to identify the advantages and disadvantages of different protocols of antihypertensive therapy in women with arterial hypertension during the process of labour and their effects on the labour progressing and perinatal complications. 

Material and methods: 228 women who had childbirth in 2013–2018 in the Ternopil perinatal centre “Mother and Child” were surveyed. The study included full-term singleton pregnancies in cephalic presentation. According to the treatment program, women were divided into 4 groups: Group 1: 58 pregnant women who neglected treatment or had insufficient compliance; Group 2: 57 pregnant women who used methyldopa and classic beta-blockers during pregnancy and labor; Group 3: 57 pregnant women who received high selective beta-blocker with vasodilating properties nebivolol in addition to methyldopa; Group 4: 56 healthy pregnant women with normal blood pressure and without other somatic pathology. 

Results: Hypertension and inadequate hemodynamic control can become risk factors for higher incidence of low birth weight, prolonged or discoordinated labour, excessive blood loss during and after delivery. The program of treating hyper- tension in pregnant women with nebivolol hydrochloride provides sufficient control of blood pressure and helps to avoid blood pressure spikes or an excessive increase of systolic and diastolic blood pressure and heart rate during childbirth, which could endanger the mother’s health. 

Conclusions: The treatment with nebivolol hydrochloride for women with chronic arterial hypertension during pregnancy and delivery allows to normalize the progress and duration of labour, decrease the incidence of low birth weight and the percentage of excessive blood loss during labour. 

Abstract

Objectives: Were to identify the advantages and disadvantages of different protocols of antihypertensive therapy in women with arterial hypertension during the process of labour and their effects on the labour progressing and perinatal complications. 

Material and methods: 228 women who had childbirth in 2013–2018 in the Ternopil perinatal centre “Mother and Child” were surveyed. The study included full-term singleton pregnancies in cephalic presentation. According to the treatment program, women were divided into 4 groups: Group 1: 58 pregnant women who neglected treatment or had insufficient compliance; Group 2: 57 pregnant women who used methyldopa and classic beta-blockers during pregnancy and labor; Group 3: 57 pregnant women who received high selective beta-blocker with vasodilating properties nebivolol in addition to methyldopa; Group 4: 56 healthy pregnant women with normal blood pressure and without other somatic pathology. 

Results: Hypertension and inadequate hemodynamic control can become risk factors for higher incidence of low birth weight, prolonged or discoordinated labour, excessive blood loss during and after delivery. The program of treating hyper- tension in pregnant women with nebivolol hydrochloride provides sufficient control of blood pressure and helps to avoid blood pressure spikes or an excessive increase of systolic and diastolic blood pressure and heart rate during childbirth, which could endanger the mother’s health. 

Conclusions: The treatment with nebivolol hydrochloride for women with chronic arterial hypertension during pregnancy and delivery allows to normalize the progress and duration of labour, decrease the incidence of low birth weight and the percentage of excessive blood loss during labour. 

Get Citation

Keywords

delivery; arterial hypertension; rational control; nebivolol hydrochloride

About this article
Title

Rational control of arterial pressure during labor in women with arterial hypertension

Journal

Ginekologia Polska

Issue

Vol 90, No 4 (2019)

Pages

206-211

Published online

2019-04-29

DOI

10.5603/GP.2019.0037

Pubmed

31059113

Bibliographic record

Ginekol Pol 2019;90(4):206-211.

Keywords

delivery
arterial hypertension
rational control
nebivolol hydrochloride

Authors

Iryna Yevhenivna Humenna
Svitlana Nikolayivna Heryak
Victoryya Yuriyivna Dobryanska

References (30)
  1. von Dadelszen P, Magee LA. Preventing deaths due to the hypertensive disorders of pregnancy. Best Pract Res Clin Obstet Gynaecol. 2016; 36: 83–102.
  2. “Hypertension in Pregnancy”, The American College of Obstetrician and Gynecologists, Task Force, 2013. http://www.acog.org/Resources-And-Publications/Task-Force-and-Work-Group-Reports/Hypertension-in-Pregnancy.
  3. Charlene H. Collier, MD, MPH, MHS, FACOG, James N. Martin Jr., MD, FACOG, FRCOG, FAHA. Hypertensive disorders of pregnancy. http://www.contemporaryobgyn.net/authors/james-n-martin-jr-md-facog-frcog-faha (10.05.2018).
  4. Bernstein PS, Martin JN, Barton JR, et al. National Partnership for Maternal Safety: Consensus Bundle on Severe Hypertension During Pregnancy and the Postpartum Period. Obstet Gynecol. 2017; 130(2): 347–357.
  5. Callaghan WM. State-based maternal death reviews: assessing opportunities to alter outcomes. Am J Obstet Gynecol. 2014; 211(6): 581–582.
  6. 2013 ESH/ESC Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). https://academic.oup.com/eurheartj/article/34/28 /2159/451304.
  7. Geller SE, Koch AR, Martin NJ, et al. Illinois Department of Public Health Maternal Mortality Review Committee Working Group. Assessing preventability of maternal mortality in Illinois: 2002-2012. Am J Obstet Gynecol. 2014; 211(6): 698.e1–698.11.
  8. Magee L, Duley L. Oral beta-blockers for mild to moderate hypertension during pregnancy. Cochrane Database of Systematic Reviews. 2003.
  9. Cleary KL, Siddiq Z, Ananth CV, et al. Use of Antihypertensive Medications During Delivery Hospitalizations Complicated by Preeclampsia. Obstet Gynecol. 2018; 131(3): 441–450.
  10. E. Martin Best treatments for sudden blood pressure spikes in labor September 2, 2016, Elm Tree Medical, Inc. http://elmtreemedical.com/blog-elmtree/2016/9/1/785acsbju3nuezrip8ohnha 27b4o6j.
  11. Abalos E, Duley L, Steyn DW, et al. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2001(2): CD002252.
  12. Ferrer RL, Sibai BM, Mulrow CD, et al. Management of mild chronic hypertension during pregnancy: a review. Obstet Gynecol. 2000; 96(5 Pt 2): 849–860.
  13. Lloyd-Jones D, Adams RJ, Brown TM, et al. WRITING GROUP MEMBERS, American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics--2010 update: a report from the American Heart Association. Circulation. 2010; 121(7): e46–e4e215.
  14. National Collaborating Centre for Women's and Children's Health (UK). Hypertension in Pregnancy: The Management of Hypertensive Disorders During Pregnancy. National Institute for Health and Clinical Excellence: Guidance. 2010.
  15. Martin JN, Thigpen BD, Moore RC, et al. Stroke and severe preeclampsia and eclampsia: a paradigm shift focusing on systolic blood pressure. Obstet Gynecol. 2005; 105(2): 246–254.
  16. Wagner SJ, Acquah LA, Lindell EP, et al. Posterior reversible encephalopathy syndrome and eclampsia: pressing the case for more aggressive blood pressure control. Mayo Clin Proc. 2011; 86(9): 851–856.
  17. Hinchey J, Chaves C, Appignani B, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med. 1996; 334(8): 494–500.
  18. Fugate JE, Claassen DO, Cloft HJ, et al. Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings. Mayo Clin Proc. 2010; 85(5): 427–432.
  19. Cipolla MJ. Cerebrovascular function in pregnancy and eclampsia. Hypertension. 2007; 50(1): 14–24.
  20. Swiet Mde. Maternal blood pressure and birthweight. The Lancet. 2000; 355(9198): 81–82.
  21. Fisher SJ. Why is placentation abnormal in preeclampsia? Am J Obstet Gynecol. 2015; 213(4 Suppl): S115–S122.
  22. Wang A, Rana S, Karumanchi SA. Preeclampsia: the role of angiogenic factors in its pathogenesis. Physiology (Bethesda). 2009; 24: 147–158.
  23. Moser M, Brown CM, Rose CH, et al. Hypertension in pregnancy: is it time for a new approach to treatment? J Hypertens. 2012; 30(6): 1092–1100.
  24. Khalil A, Harrington K, Muttukrishna S, et al. Effect of antihypertensive therapy with alpha-methyldopa on uterine artery Doppler in pregnancies with hypertensive disorders. Ultrasound Obstet Gynecol. 2010; 35(6): 688–694.
  25. Magee LA, Cham C, Waterman EJ, et al. Hydralazine for treatment of severe hypertension in pregnancy: meta-analysis. BMJ. 2003; 327(7421): 955–960.
  26. Alabdulrazzaq F, Koren G. Fetal safety of calcium channel blockers. Can Fam Physician. 2012; 58(7): 746–747.
  27. Easterling TR. Pharmacological management of hypertension in pregnancy. Semin Perinatol. 2014; 38(8): 487–495.
  28. Petersen KM, Jimenez-Solem E, Andersen J, et al. β-Blocker treatment during pregnancy and adverse pregnancy outcomes: a nationwide population-based cohort study. BMJ Open. 2012; 2(4): e001185.
  29. Ignarro LJ. Experimental evidences of nitric oxide-dependent vasodilatory activity of nebivolol, a third-generation beta-blocker. Blood Press Suppl. 2004; 1: 2–16.
  30. Henriques AC, Carvalho FHC, Feitosa HN, et al. Endothelial dysfunction after pregnancy-induced hypertension. Int J Gynaecol Obstet. 2014; 124(3): 230–234.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk
tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl