What treatments are safe and effective for mild to moderate hypertension in pregnancy?

Abstract

There is considerable debate concerning the treatment of mild to moderate essential hypertension during pregnancy. Evidence suggests that because of the potential risk of fetal intrauterine growth restriction, treatment of hypertension should be delayed until maternal blood pressure reaches 150-160 mm Hg systolic or 100-110 mm Hg diastolic, as long as the mother has no preexisting end organ damage. Methyldopa has been the drug of choice for oral treatment, as it is the only medication to have any extended follow-up study. However, a recent meta-analysis raised the possibility of increased fetal mortality (strength of recommendation [SOR]: A, based on systematic review of randomized controlled trials).