Antihypertensive not used in the management of PIH is:
Correct Answer: Propranolol
Description: Ref. KDT. Page. 145
Anti-hypertensives to be avoided during pregnancy
Diuretics: Tend to reduce blood volume— accentuate uteroplacental perfusion deficit (of toxaemia)—increase risk of foetal wastage, placental infarcts, miscarriage, stillbirth.
ACE inhibitors, AT antagonists: Risk of foetal damage, growth retardation.
Nonselective b blockers: Propranolol has been implicated to cause low birth weight, decreased placental size, neonatal bradycardia and hypoglycaemia.
Sod. nitroprusside: Contraindicated in eclampsia.
Antihypertensives found safer during pregnancy
Hydralazine
Methyldopa (a positive Coombs’ test occurs, but has no adverse implication).
Dihydropyridine CCBs: discontinue before labour as they weaken uterine contractions.
Cardioselective b blockers and those with ISA, e.g. atenolol, metoprolol, pindolol, acebutolol: may be used if no other choice.
Prazosin and clonidine—provided that postural hypotension can be avoided.
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