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Old 06-14-2011
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ObGyn Gestational Hypertension Treatment (drugs or conservative)

should we treat patient with gestational HTN , chronic HTN in pregnancy

OR just conservative ?

Is there any general role with this concept ?
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Old 10-06-2011
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Answer: Normally doctors will advice life style monitor. However, if at any stage the gestational hypertension raises the suspicion of pre-eclampsia, Methyldopa should be administered. Dose is normally 250 mg orally twice daily initially, increase every 2 days according to response, maximum 2000 mg/day given in 2-4 divided doses.

By they way, in case you are interested in the mechanism of gestational hypertension: a school of thought states that insulin resistance may mediate the clinical onset of hypertension in pregnancy. While others believe BP is usually elevated in pregnancy due to upregulation of the renin-angiotensin-aldosterone system. Whereas in healthy pregnant women this is balanced by a drop in the systemic vascular resistance (SVR) as well as in cardiac output, in women with gestational hypertension SVR remains low but cardiac output tends to increase. It is unclear whether gestational hypertension and pre-eclampsia represent distinct pathologies or are varying aspects along a single pathophysiological spectrum.

Last edited by HaipengWang; 10-06-2011 at 06:43 AM.
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