Pills for low blood pressure for pregnant women. What pills to reduce pressure during pregnancy at different times? Test to be taken

Fluctuations are normal. It becomes a significant problem if its cause is not a child growing in the womb, but disturbances in the work of the cardiovascular, endocrine, nervous, and genitourinary systems of organs. What methods and means of treatment can be used for a pregnant woman with high blood pressure?

The danger of high pressure and the importance of diagnosis

Treatment of a pregnant woman is fraught with violations in the health of the unborn child and the pregnant woman herself. Making an accurate diagnosis allows you to choose the dosage of drugs for a woman and a child as accurately as possible, determine which ones are suitable in a particular case (for problems with the thyroid gland or kidneys, they will differ significantly), in which combination to take them. The main issue that the doctor must decide is the very possibility of bearing a healthy child in the absence of a mortal danger for a hypertensive woman.

Usually, women experience a decrease in pressure in the first and second trimester by 10-15 points from the usual level, and in the third - an increase in comparison with the norm for a woman by 10-15 points. Such fluctuations are considered the norm, they do not need to be adjusted with drugs.

Important! Pay attention to the prescription of drugs by the attending physician: for each medication, a clear argument is needed. Her absence is a reason to change the medical worker.

With an "upper" pressure of 150, and a "lower" pressure of 95, there is a reason for examining a pregnant woman, additional ones. Treatment with any drugs has the main goal of preventing the development, or. Pathological pressure surges are fraught with significant consequences:

For woman:

• stroke;
• bleeding;
• retinal detachment;
• convulsions;
• death.

For a child:

• developmental delay;
• asphyxia;
• oxygen hunger;
• premature birth;
• death.

If high blood pressure is detected, a pregnant woman is advised to undergo an examination by a cardiologist, ophthalmologist, endocrinologist, neuropathologist. Of the analyzes - general blood and urine tests, ultrasound of the kidneys, cardiogram.

Methods for the treatment of hypertension in pregnant women

The choice of treatment for a pregnant woman is always carried out on an individual basis. Depending on the severity of the manifested hypertension, the following is prescribed:

• unambiguous rejection of bad habits (smoking, alcohol);
• vitamin therapy, taking mineral-containing preparations;
• moderate diet;
• avoidance of strong physical exertion and stress, but mandatory walking and a set of exercises;
• the use of drugs based on herbs to lower pressure;
• antihypertensive tablets with a short duration of action (short-term intake);
• regular treatment with antihypertensive drugs;
• treatment with a complex of drugs to reduce pressure at home or in a hospital;
• emergency treatment in a hospital with the possibility of premature birth.

It is best if during the day the woman will be under the supervision of physicians, and they will take pressure measurements (at least once every 4 hours), and conduct proper tests.

Safe and/or required drugs

Taking any antihypertensive drugs during pregnancy must be agreed with the doctor!

Recommended pills for pressure during pregnancy, including in order to minimize the possibility of manifestation of hypertension, are "Magnicum", "Magne B6", or their analogues. They are not hypotensive. The essence of the action: saturation of the nervous system with minerals and vitamins, which have a general calming effect, contribute to the normal conduction of nerve impulses, dilate blood vessels, and as a result, do not allow pressure to rise due to stress factors.

In the first trimester, it is also important to take "Folic Acid": the drug reduces the risk of developing neural tube defects, increases the level of hemoglobin. In the second trimester, iodine preparations are connected. May be appropriate throughout pregnancy. Contraindications to treatment with these drugs may be personal intolerance, renal, hepatic failure.

Taking magnesium preparations in the early stages has a positive effect on the treatment of hypertension after 20 weeks: the dosage of antihypertensive drugs is significantly less than in patients who did not take magnesium.

The use of no-shpy can be considered conditionally harmless: a vasodilator drug allows you to relieve spasm, relax smooth muscles. Lowering the pressure with this drug is possible with minor deviations from the norm, in parallel it reduces the pain syndrome (headaches, abdominal muscle cramps).

Conditionally safe medicines and their combinations

It has been noticed that taking any medication for pressure during pregnancy can affect the intrauterine development of the fetus, or affect the further development of the child. With all the risks, there is a list of permitted drugs, which differs significantly in medical practices in different countries. Doctors judge the severity of the consequences of drug use based on a few animal studies, data on women and the development of newborns who were treated during pregnancy, and personal medical experience. Medications are also prescribed depending on the duration of pregnancy.

Important! The only drug for high blood pressure, the effect of which was observed for almost 8 years, was Methyldopa: no adverse reactions were found in mothers, newborns, developmental abnormalities in children who have reached the age of seven.

Depending on the availability of information about the negative outcome of treatment, drugs for high blood pressure are classified into the following groups:

Group	A drug	Influence
A (safe)	Calcium, magnesia, magnicum, aspirin (in small doses)	There was no negative effect on the woman or the child.
B (conditionally safe)	Hydrochlorothiazide, methyldopa	There was no negative effect on the fetus and the pregnant woman. Negative results in animals have not been confirmed in humans.
C (harmful)	Papaverine, nifedipine, clonidine, labetalol, hydralazine	No formal human studies have been conducted, or there is little evidence of adverse effects in humans with treatment. Animal studies have shown a clear strong effect on the fetus. We can assume that the risk of taking the drug is justified.
D (toxic)	Aspirin (in doses greater than 150 mg per day)	It can be used only if there is no alternative in an acute crisis situation.
X (poisons)		The risk of taking the drug is not justified. Guaranteed severe consequences for the fetus.

Usually combined:

1. Methyldopa and diuretics (side effects from taking the first medication - swelling, stopped by diuretics).
2. Methyldopa and calcium antagonists (the latter change the heart rate).
3. Methyldopa and beta-blockers (decrease in vascular tone, the amount of blood in one ejection).
4. , hydrochlorothiazide, beta-blockers.
5. Calcium antagonists, clonidine, diuretics, beta-blockers.

The combination of pressure pills for pregnant women, the dosage and duration of treatment depend on the causes of hypertension.

Important! Acute conditions (very high blood pressure) of a pregnant woman can be relieved with magnesium preparations, nifedipine, lebatalol, hydralazine, nitroglycerin.

Permanent treatment (daily use of the drug to control pressure) can be carried out through the administration of dopegyt. The drug gives good results, but after a month or two after administration, there is a need to increase the dose. The usual daily norm is to drink 3-6 tablets for pressure.

The effect for 12-24 hours at high pressure is provided by methyldopa and all medicines from group B. The dosage is calculated with the attending gynecologist, often in cooperation with a cardiologist and endocrinologist.

Hospitalization

Women with hypertension before pregnancy fall under planned inpatient treatment. It should be noted that patients suffering from hypertension are advised by doctors not to become pregnant at all. The fact is that during pregnancy, health risks are too high, primarily for the mother due to high blood pressure (thrombosis, stroke, hemorrhage). It is necessary to treat chronic non-gestational hypertension with drugs that have a pronounced toxic effect, which will cause severe complications in the development of the child. The scenario will be the more likely, the higher the age of the mother, and the more concomitant diseases.

In the early stages, hypertension causes abortion. Antihypertensive drugs in early pregnancy are prescribed, but the risks are high. A visit to the doctor in the second trimester of pregnancy is mandatory in order to adjust the intake of drugs, taking into account the development of the circulatory system of the fetus, its general physical parameters. For hypertensive women in the third trimester, hospitalization will help prepare for the proper management of childbirth, possible complications with the health of the child.

Patients in whom hypertension has led to preeclampsia, eclampsia are also subject to treatment in a hospital setting.

Can lead to delivery by caesarean section, sometimes to the birth of a child prematurely.

Prognosis for mother and child

Modern medicine cannot yet guarantee a 100% successful outcome for a woman and a child in the treatment of hypertension with antihypertensive drugs. With timely and proper treatment, it is possible to achieve gestation for the full term of pregnancy, childbirth by natural means, minimal or undiagnosed abnormalities in a child at birth. In any case, after childbirth, both the mother and the child should be registered with a pediatrician and a cardiologist for at least a year.

In the future, parents should take care of a healthy lifestyle for their child so that genetic predisposition and early treatment do not become the causes of his hypertension.

Pregnant hypertension can be turned from a death sentence for a child into minor complications during gestation, but only with the help of the right medication, preventive therapy, and a healthy lifestyle for the woman in labor. The existing number of drugs makes it possible to individually select them, solve the problem without harming the child, or with minimal complications.

Pills for pressure during pregnancy should be prescribed exclusively by a specialist. The choice of drug therapy is carried out under the supervision of a gynecologist and a cardiologist. When prescribing drugs, it is important to be careful, since many of them are contraindicated during the period of bearing a baby. What can pregnant women from pressure?

Causes of hypertension

During pregnancy, the female body undergoes many changes that affect the hormonal system. As a result of these processes, there is a risk of developing pathologies of the heart and blood vessels.

One of the severe violations is. Its appearance is quite natural, because during the period of bearing a child, much more blood is produced - its amount increases by 1.5 times. As a result, the load on the heart and blood vessels increases significantly.

Common factors that provoke the development of hypertension include the following:

• Hormonal imbalance;
• Excess weight;
• Diabetes;
• Congenital lesions of the kidneys and thyroid gland.

Possible dangers

According to various estimates, hypertension is recorded in 5-30% of cases. Its appearance can pose a danger to the mother and fetus. Therefore, this problem should be taken very seriously.

True hypertension is called
a situation that is characterized by a pressure indicator of 140/90 mm Hg. Art. However, to confirm the diagnosis, at least 2-3 measurements are required, which are taken at intervals of 4 hours. Only in difficult cases of hypertension, which is characterized by an indicator of 160/110 mm Hg. Art., it is worth using tablets. In other situations, non-drug methods are used.

It is important to consider that the development of hypertension during pregnancy can provoke the following disorders:

1. Placental abruption and severe bleeding;
2. Detachment of the retina - develops against the background of a combined pathology of the organ of vision;
3. The low score of the child on the Apgar scale is due to fetal hypoxia.

Placental abruption and severe bleeding

Low blood pressure is quite common in the first trimester of pregnancy. The key reason for the anomaly is a change in the balance of hormones. Almost all women in the early stages constantly want to sleep, experience dizziness and nausea.

Principles of treatment

With the development of hypertension in pregnant women, it is very important to be under constant medical supervision. In this situation, the control of a cardiologist and a gynecologist is required. Even with small deviations in the state of health, a woman should be immediately hospitalized.

A patient with arterial hypertension needs to go to the hospital three times under medical supervision. Physicians decide on the treatment regimen. In the initial stages of hypertension, the list of approved drugs is not too extensive. Such medications can cause miscarriage.

At the end of the first trimester, a woman is hospitalized for an accurate diagnosis. Between 25 and 30 weeks, the patient is examined to monitor changes in her condition and the health of the fetus. At 38 weeks and until delivery, the woman is observed to monitor the dynamics of her condition. As a result, the patient and the child are constantly under medical supervision.

Overview of effective drugs

Pills for high blood pressure during pregnancy are divided into several categories. Each group has certain characteristics.

Beta blockers

This group includes tools such as,. They help inhibit the action of adrenaline on the heart muscle. Due to this, it is possible to reduce the load on the organ, to cope with the symptoms of tachycardia and other rhythm disturbances.

Calcium channel blockers

These tools include and. The mechanism of action of these drugs is based on a decrease in the intensity of heart contractions, vasodilation and normalization of blood flow. With a long study of these drugs, it was possible to find out that they do not produce a negative effect on the fetus or have a slight effect.

Nifedipine

However, it is important to consider that calcium channel blockers can lead to negative reactions in the body. They manifest themselves in the form of hypotension, heart rhythm disturbances, headaches, sensations of heat.

It is not recommended to combine the use of nifedipine with magnesium sulfate or magnesia. Such combinations provoke neuromuscular blockade and a rapid decrease in pressure. There is evidence that magnesium preparations are allowed to be combined with nimodipine.

Antispasmodics

This category includes drugs such as papaverine, no-shpa,. These funds help reduce the tone of the uterus and intestines. This effect is achieved by expanding the vascular lumen. Such drugs improve placental circulation. This helps to reduce the risk of developing congenital anomalies in a child.

Such funds have practically no contraindications. However, in some situations, they provoke undesirable reactions, which manifest themselves in the form of high-intensity headaches, insomnia, nausea and vomiting.

Diuretics

These include and. Diuretics can be drunk with arterial hypertension only if the pregnant woman is under the supervision of a specialist. This is due to the risk of circulatory disorders in the placenta.

Hydrochlorothiazide

Diuretics successfully stabilize blood pressure. Many drugs are allowed to be taken in late pregnancy.

Another effective diuretic is. However, this substance can be used due to the development of hypertension, which is the result of kidney or heart failure.

Alpha 2 agonists

This group includes pressure pills for pregnant women such as methyldopa and dopengyt. Substances whose active ingredient is have been used for a long time. During the period of use of the drug for the treatment of pregnant women, no negative effects were recorded.

These substances affect the brain. They allow you to quickly achieve results due to the expansion of blood vessels and a decrease in heart rate. Adverse reactions are extremely rare. These include dryness in the oral cavity, increased drowsiness, arterial hypotension.

Magnesium preparations

Means such as magnelis, magnefar, can be taken without much concern. Such drugs have a hypotensive effect, dilate blood vessels, cope with convulsions and soothe. They are most often prescribed by injection.

Magnesium preparations very rarely provoke side effects. These include inhibited reactions, nausea, doubling of objects, hot flashes. Specific tablets from this group should be selected by a doctor.

Vitamin complexes

Pregnant women are often prescribed drugs such as femibion, vitrum prenatal. Their action is aimed at saturating the body of a pregnant woman with the necessary substances.

With the right choice of the drug, it will be possible to reduce pressure indicators, normalize the functioning of the heart and blood vessels, without harming the development of the child and the state of health of the mother.

Sedative drugs

Pregnant women are prescribed herbal remedies that are completely safe. They help to cope with high blood pressure without any threats. However, taking such drugs is allowed only in the absence of allergic reactions to their ingredients.

Due to the sedative effect, such drugs eliminate the tension of the nervous system, normalize blood pressure, and calm the cardiovascular system. Such drugs practically do not cause adverse reactions. The only consequence of the application is increased drowsiness.

Features of combination therapy

In difficult cases of pathology, doctors select combined drugs for pressure during pregnancy. Sometimes you have to use 2-3 drugs at once. Thanks to this method of treatment, it is possible to reduce the dosage of potent agents and minimize toxic effects.

Therapy of pregnant women can be carried out according to a double or triple scheme. The main drug in this case is methyldopa, which is part of drugs such as dopengit and methyldopa. This drug is an adrenergic blocker and a dihydropyridine calcium antagonist.

The most well-known options for complex treatment include the following:

• Dopengyt in combination with a calcium antagonist, beta-blocker or diuretic;
• Alpha-blocker in combination with a beta-blocker - this scheme is used for hypertension associated with pheochromocytoma;
• Dihydropyridone calcium antagonist in combination with an alpha, beta blocker or.

If a triple treatment regimen is used, the following options are possible:

1. Dopengyt in combination with a beta-blocker, diuretic or dihydropyridine calcium antagonist;
2. Dopengit in combination with a diuretic and a calcium antagonist;
3. Nifedipine in combination with a small amount of hydrochlorothiazide and a beta-blocker.

In some situations, it is allowed to combine 4 medicinal substances at once:

Prohibited drugs

During pregnancy, not all drugs for pressure can be used. Prohibited substances include.

Hypertension is a common problem in pregnant women. At the same time, it is dangerous to ignore the pathology, since such deviations can harm not only the mother, but also the fetus. The main difficulty in this is that most of the pills that can lower the pressure are contraindicated when carrying a child.

Why is high blood pressure dangerous during pregnancy?

Even in the early stages of pregnancy, an increase in blood pressure is a dangerous factor that can cause preeclampsia. This unpredictable disease can stimulate the malfunctioning of various important ones, including the cardiovascular and circulatory systems. The disease develops as a result of the production by the placenta of substances that form micro-holes in the vessels (through which protein and plasma fluid enter the tissues). This causes the appearance of swelling on the legs, hands, placenta. Edema of the latter threatens with serious consequences for the fetus.

Even in cases where high blood pressure in pregnant women does not cause preeclampsia, the pathological condition cannot be ignored. It is not for nothing that antenatal clinic workers pay great attention to monitoring changes in blood pressure in pregnant women: as a result of pressure surges in the vessels of the placenta and fetus, blood circulation between the woman and the baby is reduced (the phenomenon is called fetoplacental insufficiency). This leads to a deficiency of oxygen, nutrients and may lead to a delay in the development of the fetus.

pressure during early pregnancy

The restructuring of the hormonal background, which actively occurs at the beginning of pregnancy, is reflected in the entire body of a woman, including the circulatory and vascular systems. As a result, high blood pressure during early pregnancy is not uncommon. However, the tonometer dial should not show more than 120/80 mm Hg. Art., otherwise the development of the fetus may not occur as laid down by nature.

Anxiety in the expectant mother should cause BP 140/90 and above, which is noted regularly. Such data indicate arterial hypertension (gestational or chronic). In the latter case, the deviations are caused by any pathologies that a woman has (often these are kidney diseases or endocrine disorders). With gestational hypertension, a violation of the blood pressure indicator causes pregnancy directly, and, as a rule, at the end of the second trimester.

At the initial stage, gestational hypertension is extremely dangerous, since it causes vasoconstriction, as a result of which the necessary substances entering the embryo are reduced. As a result of this pathological condition, fetal development may be delayed. In addition, a possible consequence of the disease in the first trimester is a miscarriage.

High blood pressure during late pregnancy

Various pathological conditions can cause deviations in blood pressure in the last trimester. Doctors associate high blood pressure during late pregnancy with preeclampsia, a complication characterized by the accumulation of fluid in the body of the expectant mother. Since ordinary arterial hypertension is difficult to distinguish from gestosis, if edema, dizziness, tinnitus and other specific symptoms appear, you should immediately see a doctor.

As a result of regular changes in blood pressure, vascular tone increases, which threatens to disrupt blood circulation in the placenta and can lead to serious disturbances in the intrauterine development of the baby. As a rule, pathology develops after the twentieth week of pregnancy, but in exceptional cases it occurs in the initial stages. At the same time, factors that increase the likelihood of hypertension in pregnant women are:

• diabetes;
• pathology of the biliary tract or kidneys;
• stress;
• the presence of excess weight;
• woman's age;
• malfunctions in the functioning of the thyroid gland;
• traumatic brain injury.

Norm of pressure during pregnancy

Almost half of pregnant women have problems with blood pressure. Normal pressure during pregnancy may fluctuate slightly, but does not go beyond the permissible, while 120/80 mm Hg is considered optimal. Art. In young women, the rate will be up to 130/85 mm Hg. Art. - such blood pressure is not capable of harming the fetus or negatively affecting the health of the expectant mother. Doctors strongly advise to monitor pressure during childbearing and write down the readings of the tonometer in a notebook every week. If blood pressure rises intermittently, it should be measured daily.

How to lower blood pressure during pregnancy

Only an experienced doctor can choose safe means and suggest what methods can be used to lower blood pressure during gestation. It is strictly forbidden to take any medications on your own, as they can cause serious harm to the baby. How to lower blood pressure during pregnancy? Taking pills for hypertension is prescribed exclusively for highly elevated blood pressure in order to reduce the risk of developing any complications. In this case, the doctor selects the appropriate dosage and treatment regimen.

How to bring down the pressure during pregnancy without medication:

• taking folk remedies;
• through diet;
• through massages, yoga and other techniques.

Pills for pressure during pregnancy

If a woman already had problems with pressure before pregnancy, then she probably already has pills in her medicine cabinet that help normalize blood pressure. However, it is forbidden to drink them without consulting a doctor, as these drugs can cause irreparable harm to the fetus or even cause a miscarriage. Without an urgent need, doctors do not advise taking drugs for pressure during pregnancy.

How to lower blood pressure during pregnancy? If the woman's health condition is not critical, the doctor prescribes the use of mild sedatives such as valerian or motherwort and the use of diuretics. If such drugs are not effective, Dopegyt or Papazol tablets are used to treat hypertension, which must be drunk in a course of 10 days. For planned therapy, Nifedipine and Metaprolol are prescribed. In addition, in order to achieve normal blood pressure, No-shpa and Papaverine can be additionally used.

Find out more about what you can take during pregnancy.

Products to reduce blood pressure during pregnancy

Fluid is retained in the body by animal fats and salt, therefore, with hypertension, it is important to limit the consumption of foods containing these substances. To bring down high blood pressure, you need to properly form your diet, excluding food from it, which can negatively affect the condition of the heart and blood vessels. Prohibited use:

• chocolate
• coffee;
• strong black tea;
• fatty meats;
• butter;
• marinades;
• fried food;
• sugar and products containing it;
• smoked meats.

It is impossible to achieve a rapid decrease in blood pressure with a balanced diet. What foods lower blood pressure during pregnancy? These include:

• cranberry juice, lingonberry juice and fresh berries;
• vegetables - carrots, pumpkin, spinach, beets, cabbage;
• any fruit.

Ways to lower blood pressure without drugs

If a pregnant woman has a moderately elevated blood pressure, it is possible to bring the tonometer to normal values ​​without even resorting to taking medications. How to reduce pressure without pills during pregnancy? The first thing to do is to normalize your own daily routine: go out into the fresh air more often, eat at the same time, play sports, and provide yourself with a good rest.

In addition, it is imperative to balance the diet, filling it with foods high in vitamins. It is important to drink enough water (you need to drink at least 1.5 liters per day). How to lower blood pressure during pregnancy at home? There are many effective ways to normalize blood pressure:

• taking a cool shower;
• yoga, gymnastics for pregnant women (it is important to take into account the duration of pregnancy up to weeks - the load should be moderate);
• an active lifestyle, including frequent walks;
• acupressure of the base of the skull;
• massaging, stretching fingers (you need to do it daily, or even several times a day).

How to lower blood pressure during pregnancy folk remedies

Since blood pressure drugs are highly undesirable during pregnancy, hypertension is often treated using alternative medicine methods. Despite the fact that they are inferior in effectiveness to medicines, with systematic use they help to remove signs of hypertension and avoid preeclampsia and preeclampsia. How can you lower blood pressure during pregnancy? For this purpose, the following folk remedies for pressure in pregnant women are used:

1. Cranberry medicine. Squeeze the juice from a glass of berries, pour the cake with boiling water and put on a slow fire for 5 minutes. Strain the broth and boil 3 tsp in it. semolina (it will take 15 minutes), adding 4 tbsp. l. Sahara. Beat the resulting mixture with a blender, mix with cranberry juice. To reduce pressure, take 3 tsp. several times a day.
2. Corn grits against blood pressure during pregnancy. To gently relieve pressure, take a mixture of ground product with warm water (6 tablespoons per glass). It is necessary to use the remedy infused during the day before meals.
3. Pumpkin decoction. Boil 200 g pumpkin, chop, mix with 1 tbsp. l. honey. Take a tasty mass to lower blood pressure during pregnancy.

Video: High blood pressure in pregnant women

How to lower blood pressure during pregnancy? If the problem is severe, medications are needed. Not all drugs are suitable for pregnant women, so only a medical specialist should prescribe therapy and control it.

During pregnancy, a woman's body is rebuilt, which affects the general condition. Most of the changes are physiological, i.e., normal for the period of pregnancy, although they can be manifested by unpleasant symptoms, such as morning sickness. At the same time, some changes can have negative consequences - these include fluctuations in blood pressure (BP). If hypotension (low blood pressure) is often a physiological condition due to changes in hormonal levels and does not pose a particular danger in the vast majority of cases, then hypertension (high blood pressure) can lead to undesirable consequences in a fairly short time, so you should immediately seek medical help to remove it, i.e. normalize it. At the same time, pressure pills during pregnancy are not prescribed immediately, first the pressure is assessed, compared with the individual norm, and it is found out whether it can be removed without pills. Medicines are prescribed when the risk from their use is lower than the one that creates high blood pressure.

Indicators of normal pressure are subject to individual fluctuations, but on average they range from 120 to 140 mm Hg. Art. systolic and from 70 to 95 mm Hg. Art. diastolic pressure.

How to lower the pressure of a pregnant woman without drugs

If hypertension is minor, first try to reduce the pressure during pregnancy at home without the help of pharmacological drugs. It will not be possible to quickly bring it down in this way, but this is usually not required under these conditions.

First of all, it is recommended to adjust the diet - eat less salt, but more vegetables and fruits, it is recommended to limit carbohydrates, especially fast ones (sugar, confectionery). Berries, as well as fruit and berry juices, have a diuretic and hypotensive effect.

With the permission of the doctor, folk remedies can also be used to reduce pressure. Pumpkin decoction with honey, freshly squeezed rowan or viburnum juice - 2 tablespoons three times a day for two weeks has an antihypertensive effect. If there is heartburn or other problems with the digestive tract, the juice can be replaced with jelly from these berries.

Soothing decoctions and teas - chamomile, mint, motherwort - have a mild property to lower pressure.

Medicines to lower blood pressure during pregnancy

The 1st trimester is a special, important period during which the laying of the organs and systems of the fetus, including the nervous system, cardiovascular, musculoskeletal, takes place. Any violations in the early stages can lead to irreversible consequences, the fetus is especially vulnerable at this time. In the first trimester, only those drugs that do not affect the fetus are allowed for use.

What can I drink to lower the pressure during pregnancy at this time? If necessary, apply Labetalol (aka Presolol, Amipress), Methyldopa (Dopegyt), Nifedipine, Metoprolol.

First of all, it is recommended to adjust the diet - eat less salt, but more vegetables and fruits, it is recommended to limit carbohydrates, especially fast ones.

To reduce pressure during pregnancy in the second and third trimester, you can use a wider range of drugs - the resistance of the child's body increases, it has a certain autonomy and stamina. However, the risk of hypertension in the later stages does not decrease, but increases, therefore, more powerful drugs are used. What means can be applied? These are diuretics - Furosemide, Verapamil, Hydrochlorothiazide (Hypothiazide), Indapamide (Arifon) as well as a wide range of adrenoblockers - Atenolol, Propranolol, Nebivalol, Talinolol and others. Widely used angiotensin-converting enzyme inhibitors - Captopril, Enalapril, Lisinopril and others. Highly effective means are calcium antagonists - Nifedipine, Amplodipine.

An additional group of drugs to combat hypertension includes alpha-blockers like Prazosin and Doxazosin, imidazoline receptor agonists - Physiotens.

When taking medications, it is necessary to monitor the dynamics of the decrease in blood pressure and take measurements every few hours.

During pregnancy, outdated drugs such as Magnesium sulfate or Papaverine hydrochloride should not be taken, especially intramuscular or intravenous administration is undesirable. They do not have a point effect, but affect the entire body, so they can harm the fetus.

What pressure is considered high and needs to be reduced

Before taking any medication, you should consult with your doctor and measure your blood pressure. Each person has his own norm, which he should know - perhaps the numbers considered high blood pressure do not pose a danger to a single woman.

In the first trimester, only those drugs that do not affect the fetus are allowed for use.

Indicators of normal pressure are subject to individual fluctuations, but on average they range from 120 to 140 mm Hg. Art. systolic and from 70 to 95 mm Hg. Art. diastolic pressure. For pregnant women, this figure is usually slightly lower. Numbers greater than 140 by 90 mm Hg. Art., are considered hypertension. A dangerous condition is an increase in blood pressure to 160 per 110 mm Hg. Art., when the signs of damage will appear quickly enough.

Why is hypertension dangerous?

A persistent and prolonged increase in blood pressure can occur independently or be caused a second time, that is, due to violations of the organs and systems that control it. The first option is called essential hypertension, has no clearly defined causes (the pathogenesis of this condition forms a vicious circle - one link provokes another, so the pressure does not decrease for a long time) and is treated symptomatically. With secondary hypertension, everything is more complicated - it may indicate damage to the heart and blood vessels, kidneys, and the endocrine system. Therapy in this case is aimed at treating the underlying disease.

Hypertension is a dangerous condition, since high blood pressure can provoke damage to the so-called target organs. These are the kidneys, liver, brain, heart. The deterioration of the mother's condition, in particular the deterioration of blood circulation, adversely affects the fetus, leading to complications:

1. Premature placental abruption, which is accompanied by bleeding and leads to fetal death.
2. Damage to shock organs, resulting in a heart attack, stroke, transient ischemic attack, acute vascular insufficiency, chronic renal failure.
3. Eclampsia as a form of extreme condition (preeclampsia), in which, due to high blood pressure during gestation, its blood circulation is disturbed. The child's cardiovascular system is inextricably linked with the mother's, so a change in the gas composition of the blood or pressure is reflected in the child.
4. Pathology of the fetus due to its hypoxia - developmental delays, damage to various organs and systems (including the brain), miscarriages in the later stages.

Video

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High blood pressure in pregnant women is common and, unfortunately, is very dangerous. Hypertension of pregnant women in Russian-speaking countries is observed in 5-30% of cases, in Western Europe - about 15%. It creates big problems for both the mother and the fetus. If you are pregnant and measurements have shown that your blood pressure is rising, then this problem should be taken as seriously as possible. First of all, gather a team of good doctors who will take care of you. If they offer to go to the hospital in advance, just in case, agree.

At the same time, there is no need to panic. Reducing the pressure to normal in a pregnant woman is real. Moreover, it may even be easier than you think, and without harm to the course of pregnancy. First of all, it is worth trying the natural methods of treatment, which are described below. They control hypertension without harmful side effects for the mother and unborn child. With a high probability, you will not need strong pills and injections. In case “chemistry” is still needed, we give the most detailed information about it too.

This article is intended for pregnant women with high blood pressure and their relatives. I don't want to scare you again. But you need to fully realize how serious this situation is. Therefore, the possible negative outcomes are listed below.

What complications are often caused by hypertension in pregnancy:

• detachment of a normally located placenta, massive bleeding;
• cerebrovascular accident in a pregnant woman;
• retinal detachment, which leads to blindness;
• preeclampsia and eclampsia (convulsions, deadly);
• delayed fetal development;
• low score of the newborn on the Apgar scale;
• asphyxia (suffocation) and fetal death.

Drinking a pill for pressure, which will be at hand, and then continue to go about your business - this is absolutely impossible to do during pregnancy. Because hypertension poses a significant risk to the fetus and to the mother herself. If you choose the wrong pills for pressure, then this can have a teratogenic effect, that is, disrupt the development of the fetus. Seeing a doctor is absolutely essential. Moreover, this should be an intelligent doctor, and not the first one who comes across. You can even take it only after he gives the “good”. And even more so, any other drugs for pressure.

Arterial hypertension in pregnant women - when is the systolic "upper" pressure? 140 mmHg and/or diastolic “lower” pressure? 90 mmHg Art. To confirm the diagnosis, you need to take at least 2-3 measurements at intervals of at least 4 hours.

If the systolic “upper” pressure is > 160 mm Hg. and/or diastolic “lower” pressure > 110 mm Hg. Art., then this is severe hypertension. If the systolic "upper" pressure is 140-159 mm Hg. and/or diastolic “lower” pressure of 90-110 mm Hg. Art., then a pregnant woman has moderate hypertension. In severe hypertension, you should immediately prescribe potent pills that are potentially dangerous to the fetus. If hypertension is moderate and there is no significant risk of complications, then it is recommended to take tests, continue to be observed by doctors, but do not rush to take pills.

Normally, from the first weeks of pregnancy until the end of the first trimester, a woman's blood pressure decreases. This happens because the vascular tone is significantly reduced. By the end of the first trimester, blood pressure is minimal and then remains consistently low throughout the second trimester. Compared to pre-pregnancy levels, during this period, the systolic “upper” pressure decreases by 10–15 mm Hg, and the diastolic “lower” pressure by 5–15 mm Hg. However, in the third trimester, the pressure rises again. By the time of delivery, it usually reaches the level that it was before pregnancy, or even by 10–15 mm Hg. exceeds it.

Until recently, arterial hypertension was diagnosed if the “upper” pressure in a pregnant woman increased by 30 mm Hg. Art. from its normal level and / or diastolic “lower” - by 15 mm Hg. Art. For example, before pregnancy, your blood pressure was usually 100/65 mm Hg. Art., and then suddenly increased to 130/82 mm Hg. Art. Previously, this situation was considered hypertension in pregnancy. However, since 2013, this diagnostic criterion has been excluded in all international official recommendations.

Basic blood pressure pills for pregnant women(don't take it on your own!)

A drug	Dose	Comments
	0.5-3.0 g / day, in 2-3 doses	In terms of 16-20 weeks of pregnancy is not recommended, because it can affect the dopaminergic receptors of the fetus
Labetalol	200-1200 mg/day, in 2-3 divided doses	May contribute to intrauterine growth retardation
	30-300 mg/day sustained release tablets	Causes tachycardia. It is especially risky to take simultaneously with magnesium sulfate (magnesia).
Cardioselective beta blockers ( , )	depends on the drug	High doses increase the risk of hypoglycemia (low blood sugar) in newborns. May reduce placental blood flow.
	6.25-12.5 mg/day	May decrease blood volume and lower potassium levels (hypokalemia)

Medicines for hypertension contraindicated in pregnant women

Note. Accidentally taking the medications listed above is not a reason to worry too much, much less have an abortion right away. You need to stop swallowing illegal drugs. Ask your doctor to prescribe the “correct” blood pressure pills instead. Next, you need to conduct an ultrasound of the fetus at the planned time - 12 weeks and 19-22 weeks.

Insulin resistance is the cause of hypertension in pregnant women in 95% of cases. The remaining 5% have another cause, and this is called secondary arterial hypertension. Almost 3% of pregnant women have hypertension due to kidney disease. Do? of these, the blood supply to the kidneys is disrupted due to problems with the vessels - renovascular hypertension. The rest? - kidney tissue damage, i.e. renoparenchymal arterial hypertension. Renal hypertension is very common. Therefore, doctors automatically prescribe for many of their pregnant patients to do ultrasound of the kidneys and ultrasound Dopplerography of the renal vessels.

In addition to insulin resistance and kidney problems, high blood pressure in pregnant women can be caused by:

• magnesium deficiency in the body;
• heavy metal poisoning - lead, mercury, cadmium;
• excessive consumption of table salt;
• taking certain medications.

Rare but severe causes of secondary hypertension: thyroid problems, acromegaly, Cushing's syndrome, primary hyperaldosteronism, pheochromocytoma. Read the article "" for more details. These causes of hypertension are especially likely in young women. Therefore, young pregnant women suffering from high blood pressure require a particularly thorough examination.

What is gestational hypertension, preeclampsia and eclampsia

There are the following options for high blood pressure in pregnant women:

1. Chronic arterial hypertension.
2. Gestational hypertension.
3. Preeclampsia.
4. Eclampsia.

Chronic hypertension - the woman's blood pressure was already high at the planning stage or began to rise in the early stages, before the 20th week of pregnancy. This is despite the fact that in the I and II trimesters, blood pressure should normally decrease. Among young women, the prevalence of chronic hypertension is low. But as the age increases, its frequency increases. Among pregnant women aged 30-39 years, chronic hypertension is observed in 6-22% of women.

If a woman suffers from hypertension and takes pills for pressure, then doctors usually categorically dissuade her from planning a pregnancy. They are right, because the risk of complications is extremely high. And these are deadly complications, and not some kind of pimple. If a hypertensive woman still decides to get pregnant, then she creates significant problems for herself, her family, and doctors will not be bored either.

If you have chronic hypertension, it is best not to get pregnant. Consider adoption or custody. Appreciate what you already have.

Gestational hypertension is when an increase in blood pressure is first recorded after the 20th week of pregnancy. At the same time, there is no protein in the analysis of daily urine or there is very little of it. Having discovered gestational hypertension, doctors will continue to carefully monitor and force the pregnant woman to take tests frequently. This is necessary in order to immediately take action if the situation suddenly starts to worsen.

If more than 0.3 grams of protein is excreted in the urine per day, then this is already preeclampsia - the next step. Severe preeclampsia can cause the negative pregnancy outcomes listed above. Gestational hypertension progresses to preeclampsia in 50% of cases. The main criterion for diagnosis is the appearance of protein in the urine of more than 0.3 grams per day. But swelling does not mean that preeclampsia has developed. Because the frequency of edema is 60%, even if the pregnancy is normal.

Diagnostics

Measurement of blood pressure should be taken after a 5-minute rest, while the pregnant woman should be sitting in a comfortable position. It is assumed that during the previous hour she did not perform any vigorous physical work. A blood pressure cuff is usually required 12-13 cm wide and 30-35 cm long, i.e. medium size. If the circumference of the shoulder is unusual - too large or vice versa small - then a special cuff is needed. Because in such cases, a conventional cuff will give a significant error in the results.

The cuff of the tonometer is placed on the arm in such a way that its lower edge is 2 cm above the elbow bend, and at least 80% of the circumference of the shoulder is covered. The gold standard for blood pressure measurement accuracy is when a doctor listens to a pulse with a stethoscope. But you can also use a regular home tonometer - automatic or semi-automatic.

Need expert advice:

• therapist (cardiologist);
• neurologist;
• ophthalmologist.

Surveys:

• electrocardiogram;
• daily monitoring of blood pressure;
• ultrasound dopplerography of the vessels of the kidneys;
• transcranial dopplerography of the vessels of the base of the brain;
• periorbital dopplerography (also for assessing cerebral blood flow).

• complete blood count + schizocytes;
• general urine analysis;
• biochemical blood test (+albumin, AST, ALT, lactate dehydrogenase, uric acid);
• hemostasiogram + D-dimer;
• Reberg's test + daily proteinuria (protein in the urine) + microalbuminuria (small-diameter protein molecules in the urine).

Typical changes in test results in the development of preeclampsia

Laboratory indicators	Changes in the development of preeclampsia
Hemoglobin and hematocrit	These figures increase due to the fact that the blood thickens. The stronger, the more severe preeclampsia. However, if hemolysis develops, the rates decrease. But this also means an unfavorable course.
Leukocytes	Neutrophilic leukocytosis
platelets	The indicator is decreasing. If less than 100 x 109 / l, then this is a sign of the development of severe preeclampsia.
Peripheral blood smear	The presence of erythrocyte fragments (schizocytosis, spherocytosis) indicates the development of hemolysis in severe preeclampsia
Hemostasiogram	Signs of DIC
Serum creatinine, Rehberg's test	If the amount of urine excreted decreases, while the glomerular filtration rate of the kidneys decreases or, conversely, increases, then this is a sign of severe preeclampsia
Uric acid	Elevated uric acid levels in the blood indicate a significant risk of difficult labor, and also predicts the transition from gestational hypertension to preeclampsia
ASAT, ALT	An increase is indicative of severe preeclampsia
lactate dehydrogenase	Increases if hemolysis develops
Serum albumin	Decreases
Serum bilirubin	Increased due to hemolysis or liver damage
microalbuminuria	If found, then maybe soon there will be proteinuria
Proteinuria	If hypertension during pregnancy is accompanied by the appearance of protein in the urine, then this should be considered preeclampsia until proven otherwise.

Table notes:

• Hemoglobin is a protein in the blood that contains iron and carries oxygen to tissues. RBCs are rich in hemoglobin.
• Erythrocytes are red blood cells. They are saturated with oxygen in the lungs, and then carry it throughout the body.
• Hematocrit is the fraction of blood volume that is made up of erythrocytes.
• Hemolysis - the destruction of red blood cells with the release of hemoglobin into the blood (adverse process). With hemolysis, the hematocrit decreases.
• DIC-syndrome (disseminated intravascular coagulation) - impaired blood clotting due to massive release of thromboplastic substances from tissues.
• Serum creatinine and Rehberg's test are tests that show how well the kidneys are working.
• AST, ALT - enzymes, an increased level of which means problems with the heart and liver.
• Lactate dehydrogenase is an enzyme involved in the oxidation of glucose.
• Microalbuminuria - the appearance in the urine of albumin, protein molecules of the smallest diameter. They are the first to appear in the urine with kidney problems.
• Proteinuria - protein molecules larger in diameter than albumin are found in the urine. Means that kidney disease is progressing.

Based on the results of examinations and tests, doctors decide whether a pregnant woman has moderate or severe preeclampsia. This is a fundamental question. If preeclampsia is moderate, then the patient is admitted to the hospital and closely monitored. But at the same time, a woman can continue to bear a child. And if the condition is serious, then the patient is stabilized, and then the issue of immediate artificial birth is decided. In any case, hospitalization for preeclampsia is necessary.

Criteria for the severity of preeclampsia

Index	Moderate
Arterial hypertension	140/90 mmHg	> 160/110 mmHg
Proteinuria	> 0.3 g, but< 5 г/сутки	> 5 g/day
Creatinine in the blood		> 100 µmol/l
Albumin in the blood	normal / reduced
Decreased amount of daily urine (oliguria)	absent	<500 мл/сут
Impaired liver function	absent	increase in ALT, AST
Platelets in the blood	norm / reduced
Hemolysis	absent
Neurological symptoms	missing
Fetal growth retardation

How to reduce blood pressure in a pregnant woman

The purpose of measures to reduce pressure in pregnant women is to prevent complications for the mother and fetus during pregnancy and during childbirth. In particular, it is desirable to prevent the transition of hypertension to. An additional goal is to minimize the overall risk of cardiovascular disease in the long term.

For the treatment of hypertension in pregnant women, first of all, they use the transition to a healthy lifestyle, and then drugs. In the first half of pregnancy, blood pressure naturally decreases. This also happens in many women with chronic hypertension. In this case, they can temporarily stop taking pills for pressure. If later the pressure rises to 150/95 mm Hg. Art. and above, then antihypertensive medication should be resumed.

Doctors and patients are interested in two main questions:

• What is the optimal blood pressure level during pregnancy?
• What to drink for pregnant women with pressure? What medications are best for reducing the risk of preeclampsia?

Unfortunately, there are as yet no results from serious clinical trials on both of these pressing issues, and therefore there are no official recommendations. However, it is clear that they really help. However, they are harmless to pregnant women. Read more about them below.

Recall that gestational hypertension is a first detected increase in blood pressure after 20 weeks of pregnancy. It is assumed that before pregnancy and in the first half of the woman's pressure was normal. If gestational hypertension is detected, the patient is often immediately admitted to the hospital to monitor her condition, clarify the diagnosis, and reduce the risk of developing preeclampsia. Treatment activities begin quickly.

If hypertension is I-II degree (blood pressure? 180/110 mm Hg), then the prognosis for carrying a pregnancy is usually favorable. But the patient needs careful observation of doctors and active treatment.

If the therapy gives a result, i.e., the pressure is moderately elevated and the functional parameters of the fetus are stable, then doctors may decide not to keep the pregnant woman in the hospital. In this case, she should go to the doctor every day (!) to monitor the course of pregnancy. However, at the first sign, a woman should be immediately hospitalized. She is examined, blood and urine tests are taken to determine the severity of the disease, the condition of the fetus, and the development of further obstetric tactics.

Taking medications for hypertension can reduce placental blood flow, which is harmful to the fetus. Therefore, a woman with preeclampsia is hospitalized and treated in a hospital to monitor the condition of the fetus daily. Blood pressure during the day is controlled not once, but several times. They also monitor the general well-being of the woman, symptoms and test results. The goal is to prolong the pregnancy, prepare for childbirth and conduct them in a planned manner. However, if there are signs of a deterioration in the condition of the mother or fetus, then an immediate delivery is carried out, that is, an artificial birth.

If preeclampsia developed against the background of chronic hypertension, i.e., the pressure was increased even before pregnancy, then the principles of treatment are the same. This is a more difficult situation, so pregnant women are more likely to have to prescribe powerful combined blood pressure pills or 2-3 drugs at the same time. Patients with chronic arterial hypertension are much more likely to have adverse pregnancy outcomes than women with gestational hypertension.

Lifestyle change

As you know, lifestyle changes are the main intervention for the treatment of hypertension, and drugs are in second place. However, for pregnant women, the recommendations are not at all the same as for other categories of patients. Traditionally, doctors recommend a low-calorie diet to lose weight and get rid of hypertension. Pregnant women are not on a low-calorie diet. Also, significant physical activity is not recommended for pregnant women, especially for women with high blood pressure. At the same time, a sedentary lifestyle is harmful to both the mother and the fetus. Walking in the fresh air and aerobic exercise at a calm pace will be useful. Avoid stressful situations carefully.

Officially, pregnant women are advised to eat a diet rich in vitamins, microelements and proteins to reduce their blood pressure. Unofficially, but very effective for hypertension helps. However, during pregnancy, if overdone, it can cause ketosis, fetal malformations, or miscarriage. Therefore, follow a low-carb diet, but eat fruits, carrots, and beets every day. Eliminate all other foods overloaded with carbohydrates that are on the banned list. Fruits, carrots, and beets contain moderate amounts of carbohydrates that will keep you out of ketosis. Also, vitamins and minerals will help the child develop.

During pregnancy, it is not recommended to limit salt in the diet in order to lower blood pressure. Because reducing salt intake reduces the volume of circulating blood, it can disrupt the blood supply to the placenta. You need to be careful about women who suffered from chronic hypertension even before pregnancy, who know for sure that salt sharply increases their pressure. This is called "salt-sensitive hypertensive patients". You can salt food, but still try not to oversalt.

Smoking and consumption of alcoholic beverages is strictly prohibited. Smoking in pregnant women dramatically increases the risk that hypertension will turn into.

What can pregnant women from pressure: drugs

With a moderate increase in pressure in pregnant women, studies have not proven the benefit of taking “chemical” pills. The risk of development, premature birth, the birth of weak children, and perinatal mortality did not decrease. The course of pregnancy and its outcomes did not improve. This means that with an arterial pressure of 140-159 / 90-109 mm Hg. Art. you should not rush to prescribe medications, except for magnesium tablets with vitamin B6. Unless there are problems with the heart, kidneys, liver, etc., and the test results are more or less normal.

What to drink for a pregnant woman with pressure - do not solve this issue yourself! The final decision on prescribing medications should be made only by a doctor. Unauthorized taking of any pills is extremely dangerous!

Hypertension medications that last 12-24 hours

Simultaneously with emergency measures, a pregnant woman is prescribed tablets for hypertension, which act for a long time, smoothly and stably. The goal is to prevent the recurrence of sudden pressure surges.

Magnesia (magnesium sulfate, MgSO4) is not officially considered a cure for hypertension. However, in severe cases, it is recommended to administer it to prevent seizures. Dosing regimen of magnesia - only intravenously, preferably using a pump. Loading dose 4-6 g of dry matter (possible scheme - 20 ml of a 25% solution - 5 g of dry matter) for 5-10 minutes; maintenance dose - 1-2 g of dry matter per hour. We strongly recommend starting early to relieve hypertension and prevent pre-eclampsia. These pills greatly reduce the risk that doctors will have to use strong drugs. Pre-coordinate the intake of magnesium-B6 with the doctor!

Pressure pills that are prescribed during pregnancy

A drug		Release form, doses	Note
		Tablets of 250 mg. Inside 500 mg - 2000 mg per day. The average therapeutic dose is 1500 mg per day, in 2-3 doses. The maximum daily dose in the US recommendations is 3000 mg, in the European recommendations - 4000 mg.	First line drug for high blood pressure in pregnancy in most countries. There were no adverse effects in animal experiments, as well as an association between the drug and birth defects when used in the first trimester in humans. It has been studied in numerous studies in comparison with other drugs for pressure, as well as placebo. Long-term effects on child development have been studied.
		Tablets of 0.075 / 0.150 mg. The maximum single dose is 0.15 mg, the maximum daily dose is 0.6 mg. Note that the maximum daily dose in the European recommendations is 1.2 mg.	The use is possible as a third-line drug for hypertension resistant to other drugs. Data on the safety of clonidine are conflicting. There were no adverse effects on the fetus. However, there are few observations, especially in the first trimester (59 women), for a final conclusion. There are numerous side effects: weakness, drowsiness, dizziness, anxiety, depression, dry mouth, anorexia, dyspepsia.
		Long-acting tablets - 20 mg, modified release tablets - 30/40/60 mg. The average daily dose is 40-90 mg in 1-2 doses, depending on the form of release. The maximum daily dose is 120 mg. Not to be confused with fast-acting nifedipine for the relief of hypertensive crises.	The most studied representative of calcium antagonists for hypertension. Recommended for use in pregnant women as a drug of first or second choice. Sufficient experience has been accumulated. Use with caution simultaneously with magnesia MgSO4 - cases of hypotension, inhibition of myocardial contractility, myocardial infarction and neuromuscular blockade have been described. However, practice shows the admissibility of simultaneous reception. The actual frequency of neuromuscular blockade is less than 1%.
		Tablets 5/10 mg. Inside 5-10 mg 1 time per day.	In the experiment on animals, no harmful effects on the fetus were revealed. It is used in pregnant women in Russia and in the USA, although there are no well-designed clinical studies of use during pregnancy.
Nicardipine			In an animal experiment, no teratogenicity was detected, however, dose-dependent embryotoxicity was found. There are data from single studies on the use during pregnancy (II, III trimester), there were no adverse perinatal effects.
Nimodipine		Not approved for use during pregnancy in Russian-speaking countries	Studied in a multicenter, open-label study of 1650 women with severe preeclampsia compared with magnesium sulfate. Treatment outcomes for neonates did not differ.
Isradipin		Not registered in Russian-speaking countries	In an animal experiment, no teratogenicity was detected. Small studies with a short follow-up period have shown the safety of use during pregnancy.
		Tablets of 2.5/5/10 mg. Inside 2.5-10 mg 1 time per day. The maximum daily dose is 20 mg.	The drug is teratogenic in rabbits. There are isolated reports (3 observations) on the use during pregnancy.
		Tablets 40/80 mg, prolonged-release tablets 240 mg. Inside, 40-240 mg 1-2 times a day, depending on the form of release. The maximum daily dose is 480 mg per day.	In an animal experiment, no teratogenicity was detected. It is used as an antihypertensive and antiarrhythmic drug. There are small studies on use during pregnancy, including in the first trimester, which have not shown an increase in risk.
		Tablets 50/100 mg. Inside, 25-50 mg 2 times a day.	Not recommended for use in pregnant women in Germany, Australia, Canada. A small study of 33 women found an association of atenolol with low birth weight. This result was confirmed in several larger studies, with the most pronounced negative effect observed in women who started taking the drug in early pregnancy and received it for a long time.
		Tablets 25/50/100/200 mg. Inside, 25-100 mg 1-2 times a day. The maximum dose is 200 mg per day.	It is currently the drug of choice for hypertension in pregnancy if a beta-blocker is appropriate. The studies did not report symptoms and signs of beta-receptor blockade in fetuses and neonates. In a placebo-controlled study with the use of metoprolol, no data were obtained indicating a negative effect of the drug on fetal development.
			In a small study that included 87 women with chronic hypertension, the effectiveness of bisoprolol from the second trimester of pregnancy was shown.
		Tablets 5/10 mg. Inside 5-10 mg 1 time per day. The maximum daily dose is 20 mg.	A report has been published in Russia on the successful use of betaxolol in pregnant women with hypertension (42 patients). Long-term effects on child development were also studied (15 children, 2 years).
		Tablets of 5 mg. Inside 2.5-5 mg 1 time per day. The maximum daily dose is 10 mg.	In the domestic medical literature, there are data on the use of nebivolol in humans during pregnancy. There were no adverse effects on the fetus, as well as on the health, growth and development of children during their first 18 months of life.
Acebutolol		Not registered in Russian-speaking countries	Single reports of studies on the use during pregnancy, including in the first trimester.
Pindolol		Tablets of 5 mg. Inside 5-30 mg per day in 2-3 doses. The maximum single dose is 20 mg. The maximum daily - 60 mg.	Studies have shown safety for the fetus. No symptoms of beta-blockade have been reported in fetuses or neonates. It had no effect on the fetal heart rate in the experiment.
		Tablets of 40 mg. Inside 80-160 mg per day in 2-3 doses. The maximum daily dose is 320 mg.	Many undesirable fetal and neonatal effects have been described when taking the drug - fetal growth retardation, hypoglycemia, bradycardia, polycythemia, and other symptoms of ?-blockade. Doses of 160 mg and above cause more serious complications, but low doses can be toxic.
Oxprenalol		Not registered in Russian-speaking countries	Studies have been published that show a low risk when used during pregnancy.
Nadolol		Tablets of 80 mg. Inside 40-240 mg 1 time per day. The maximum dose is 320 mg per day.	There are data from single studies on the use during pregnancy, including in the first trimester. There are reports of symptoms of β-blockade in fetuses and newborns.
Timolol		Not registered in Russian-speaking countries (eye drops only)	Single reports on the use of the drug in women during pregnancy.
Labetalol		Not registered in Russian-speaking countries	It has vasodilating properties due to the blockade of?-receptors of blood vessels. In many international recommendations, it is a first or second line drug for hypertension in pregnant women. Along with methyldopa, it is the most commonly prescribed antihypertensive drug in the world for pregnant women. Numerous studies have shown safety for the fetus. It did not affect the fetal heart rate in the experiment. Compared with beta-blockers, the ability to cross the placenta is poorly expressed. May cause neonatal hypoglycemia (low blood sugar) when used in high doses.
Prazosin		Tablets 1/5 mg. The initial dose is 0.5 mg, the target dose is 2-20 mg in 2-3 doses.	There are isolated reports of use in humans. Not recommended by the Society of Obstetricians and Gynecologists of Canada (2008), due to an increase in stillbirths compared with nifedipine in one small study in the treatment of early severe hypertension. Recommended by the Society of Obstetricians and Gynecologists of Australia and New Zealand (2008), along with nifedipine and hydralazine, as a second line drug.
Doxazosin		Inside, initial dose 1 mg, maximum - 16 mg	No reports of use in humans
		Tablets of 25 mg. Inside 12.5-25 mg per day.	Can be used in chronic hypertension as a third-line drug. Most of the controlled studies included pregnant women with normal blood pressure who did not suffer from hypertension. In 567 cases, no specific anomalies were observed when used in the first trimester of pregnancy. Similar data were obtained from the analysis of the Danish (232 pregnant women) and Scottish (73 patients) registers. However, in the recommendations of the National Institute for Health and Clinical Excellence in the UK (2010), use in the first trimester is not recommended. Fetal safety data are rated as conflicting.
		Tablets of 40 mg. Inside 20-80 mg per day	The use is justified if pregnancy is complicated by renal or heart failure.
		Tablets of 1.5 and 2.5 mg. Inside 1 time per day.	Data on the use of indapamide during pregnancy is limited - 46 observations of use in the first trimester.
Hydralazine		Tablets of 25 mg. Inside 50-200 mg per day in 2-4 doses. The maximum dose is 300 mg per day.	No teratogenic effects have been noted in humans. It is used abroad to provide emergency care for severe hypertension during pregnancy. Not recommended for planned therapy. Cases of thrombocytopenia in the newborn and lupus syndrome in the mother are described.
Isosorbide dinitrate		Tablets of 5 mg.	There is little experience with the use of nitrates in gestational hypertension and preeclampsia, and as a tocolytic. There were no toxic effects on the fetus. The use of isosorbide dinitrate may reduce the risk of ischemia and infarction with a decrease in blood pressure.

Among calcium antagonists, pregnant women with hypertension are most often prescribed verapamil, amlodipine, and especially long-acting nifedipine. Their side effects are nausea, headache, dizziness, allergic reactions, swelling of the legs, excessive pressure drop.

With regard to beta-blockers, no teratogenic effect was noted in animal studies in any of the representatives of this group. However, neonatal complications have been reported in humans when prescribing beta-blockers:

• low blood sugar (hypoglycemia);
• respiratory depression;
• low blood pressure.

With the use of beta-blockers, it is possible that labor will occur prematurely, but this rarely happens.

Benefits of beta-blockers for treating hypertension during pregnancy:

• gradual onset of action;
• the volume of circulating blood does not decrease;
• do not cause orthostatic hypotension;
• reduction in the frequency of respiratory distress syndrome in newborns.

Side effects:

• heart rhythm disturbances (bradycardia);
• bronchospasm;
• weakness, drowsiness;
• dizziness;
• depression, anxiety (rare);
• the possibility of developing a withdrawal syndrome.

Recall that ACE inhibitors and angiotensin II receptor antagonists (sartans) are categorically not recommended for the treatment of hypertension in pregnant women.

Most often, from hypertension, pregnant women are prescribed:

• methyldopa (dopegyt);
• long-acting nifedipine;
• cardio-selective beta-blockers (primarily metoprolol).

Which drug helps better - there are no official recommendations. In the first trimester of pregnancy, the use of methyldopa, nifedipine and labetalol is allowed in the first place. Atenolol is not recommended during pregnancy. If a woman has been treated for hypertension with ACE inhibitors or angiotensin II receptor blockers, then these medications should be stopped before pregnancy. And even more so, as soon as an unplanned pregnancy is diagnosed.

Why methyldopa is the most popular drug

Combined hypertension medications for pregnant women

In severe cases, pregnant women can and should take combined medicines for pressure. These are several different drugs that you need to drink at the same time as prescribed by the doctor. They can be under one shell or 2-3 different tablets. Combination drug treatment of hypertension often allows for lower doses of drugs and thus reduces the risk of side effects.

Two-component combination treatment regimens for hypertension suitable for pregnant women:

• methyldopa + calcium antagonist;
• methyldopa + diuretic;
• methyldopa + beta-blocker;
• dihydropyridine calcium antagonist + beta-blocker;
• dihydropyridine calcium antagonist + alpha-blocker;
• dihydropyridine calcium antagonist + verapamil;
• alpha-blocker + beta-blocker (this combination is used if the cause of hypertension is pheochromocytoma).

Schemes for the combined treatment of hypertension in pregnant women from three medicinal components:

• methyldopa + dihydropyridine calcium antagonist + beta-blocker;
• methyldopa + calcium antagonist + diuretic;
• methyldopa + beta-blocker + diuretic;
• a dihydropyridine calcium antagonist (usually nifedipine) + a beta-blocker + a diuretic (usually low dose hydrochlorothiazide 6.25-12.5 mg/day).

Possible schemes of four components:

• methyldopa + dihydropyridine calcium antagonist + beta-blocker + diuretic;
• methyldopa + dihydropyridine calcium antagonist + beta-blocker + alpha-blocker;
• + dihydropyridine calcium antagonist + beta-blocker + diuretic + clonidine (clophelin).

When is hospitalization needed?

If a woman has increased blood pressure during pregnancy or had chronic hypertension even earlier, then she is admitted to the hospital 3 times in a planned manner:

1. In the early stages up to 12 weeks - to resolve the issue of the possibility of carrying a pregnancy.
2. 26-30 weeks. During this period, pregnancy creates the maximum load on the blood vessels. Usually, a correction of the blood pressure medication regimen is needed, which is carried out in a hospital.
3. 2-3 weeks before delivery. Prepare for childbirth, determine the tactics of their conduct.

A pregnant woman should be immediately admitted to the hospital if the following circumstances or signs are identified:

• Severe hypertension, pressure? 160/110 mm Hg.
• High blood pressure was first discovered during pregnancy.
• Analyzes or symptoms indicate the development of preeclampsia, the protein content in the daily urine increases.

conclusions

In the article, we examined in detail the question of how to reduce pressure in a pregnant woman in order to prevent seizures and other complications. We discussed how to switch to a healthy lifestyle in order to better control hypertension, create good conditions for the development of the fetus. Helps effectively with hypertension. Eliminate sugar, bread and flour products, potatoes and even cereals from your diet. This will quickly reduce the pressure to almost normal. However, during pregnancy, it is imperative to eat fruits, beets and carrots so that there is no ketosis.

You learned in detail which pressure pills you can drink for pregnant women, and which ones are absolutely not suitable. Some drugs are taken to quickly reduce pressure, while others are drunk daily so that there are no jumps. In any case, do not take any pills on your own initiative! Unauthorized medication during pregnancy is extremely dangerous. It can lead to miscarriage, physical and mental malformations of the fetus. You need a doctor who will correctly prescribe medications. If you do not trust your doctor - contact another specialist.