Fetal and uteroplacental haemodynamics during short‐term atenolol treatment of hypertension in pregnancy

Abstract

Summary Fetal circulation was studied by means of combined realtime and pulsed Doppler ultrasound in 14 women with pregnancy‐associated hypertension before and during the first and third days of treatment with the β1‐selective blocker, atenolol; in seven of the women the maternal uterine arcuate blood velocity waveform was also studied. Blood flow characteristics were normal both in the fetus and in the maternal arcuate artery, compared with those in uncomplicated pregnancies of corresponding gestational ages. Volume blood flow remained unchanged in the fetal descending aorta, and in the umbilical vein during atenolol treatment, whereas the pulsatility index increased in the fetal descending aorta and in the arcuate artery. This suggests that the peripheral vascular resistance, both on the maternal and fetal side of the placenta, increased during short‐term antihypertensive treament with atenolol.

Meta-Analysis of Test Accuracy Studies with Multiple and Missing Thresholds: A Multivariate-Normal Model

“…Pre-eclampsia is a major cause of maternal and perinatal morbidity and mortality, and occurs in 2-8% of all pregnancies [21][22][23][24]. The diagnosis of pre-eclampsia is determined by the presence of elevated blood pressure combined with significant proteinuria (≥ 0.3 g per 24 hour) after the 20 th week of gestation in a previously normotensive, non-proteinuric patient [25].…”

Randomised controlled trial of atenolol and pindolol in human pregnancy: effects on fetal haemodynamics.

“…A significant decrease in both maternal and fetal heart rate was seen in the atenolol group but not in the pindolol group, confirming previous findings.' 6 The most important findings were, however, that the pulsatility index and consequently the peripheral vascular resistance increased consistently in the fetal aorta and umbilical artery after atenolol treatment …”

Uso do Verapamil em Gestantes Hipertensas Crônicas: análise do Fluxo das Artérias Uterinas e Umbilical

“…Este talvez tenha sido o primeiro sinal de alerta para a não-preferência por este β-bloqueador, conduta esta que vem se fortalecendo. Montan et al 22 , em trabalho bem elaborado, observaram que o atenolol aumentava a resistência vascular uteroplacentária e fetoplacentária. O estudo comparava os mesmos parâmetros em pacientes submetidas ao pindolol, concluindo que este efeito deletério não acontecia com o segunda droga.…”