i got this information from BPR CD
· The drug of choice for high blood pressure diagnosed during pregnancy is methyldopa.
Methyldopa has been studied extensively and is well tolerated in this population.
·· Llabetolol (alpha and beta-blocker) is a commonly used second-line agent - especially for resistant hypertension in the third trimester - other beta-blockers are less often used, especially before 28 weeks gestation, because of concerns that their use may lead to an inhibition of fetal growth.
· Diuretics are not generally used in the management of hypertension in pregnancy - this is because diuretics have the theoretical potential to further reduce the circulatory volume in women with pre-eclampsia.
· According to the JNC VI guidelines, pregnant women can be continued on most antihypertensive medications with the exception of angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (Category X).
· ACE inhibitors are associated with chronic abnormalities (e.g., renal insufficiency requiring dialysis, growth retardation, and cranial malformations) andeven death of the fetus.
· When parenteral therapy is required, hydralazine is an effective alternative.