Abstract

ANTIHYPERTENSIVE MEDICATIONS IN PREGNANCY: A SYSTEMATIC REVIEW OF EFFICACY, SAFETY, AND CLINICAL GUIDANCE

Rudri D. Mehta*, Mansi Desai, Khushbu Dani, Kalgi Chaudhari, Jaymina Panthaki, Ashok Kumar, Divyakant Patel

Abstract

Hypertension affects a growing number of reproductive-age women, posing risks during pregnancy. This systematic review synthesizes evidence on antihypertensive efficacy, safety, and guidance, drawing from a cohort of 1,641 HDP patients and broader literature. Key findings highlight beta-blockers and methyldopa as safe first-line options for chronic and gestational hypertension, with calcium channel blockers as alternatives. RAAS inhibitors are contraindicated due to fetal harms. Management involves BP control to 110–140/85 mmHg, preeclampsia screening, and fetal monitoring. Guidelines stress pre-conception drug switching from teratogens. Outcomes vary by HDP type, with treated patients showing demographic differences. This underscores the need for tailored, multidisciplinary approaches to improve maternal-fetal health.

Keywords: Hypertension, Pregnancy, Antihypertensives, Preeclampsia, Safety, Efficacy, Guidelines, Methyldopa, Labetalol, RAAS inhibitors.