engleski

USING ANTIHYPERTENSIVE DRUGS DURING PREGNANCY

Objective: During pregnancy, a number of changes occur in the woman's body. Prescribing drugs pose a challenge to the physician to balance optimal treatment of the maternal symptoms and disease against the possible harm to the fetus. The aim of the study was to assess the prevalence of antihypertensive drug use and the rate of congenital malformations in neonates at in utero exposure to these drugs. Design and method: The study was performed at departments of gynecology and obstetrics in four medical institutions in Zagreb and was conducted by use of a simple structured, standardized questionnaire that consisted of two parts: mother’s interview and hospital records. This study involved 893 pregnant women. Results: At least one drug was used during pregnancy and early postpartum period by 96, 2% of 893 study women, with a mean of 2, 7 drugs per woman. During the first trimester of gestation, which is most important for fetal development, drugs were taken by 859 (96.2%) women. The relatively large number of women used atenolol during pregnancy (a total of 82 or 9.2%) ; before pregnancy it took seven women, in the first trimester 17 pregnant women, in the second 32 and in third 62 pregnant women, which indicates that the number of pregnant women taking this medicine increased in parallel with the duration of pregnancy. According to the FDA classification, atenolol belongs to category D. Among the women who have birth children with heart and blood vessel malformations, one has taken atenolol during the entire pregnancy. It is a negligible percentage of impressions malformations and can not relate taking atenolol with the emergence of malformations of the heart and blood vessels. Calcium channel blockers verapamil has been taken one woman in the first, 11 in the second and 17 in the third trimester. Nifedipine have used a negligible number of women (three in the first, two in the second and four in the third trimester). Eight women have been used ACE inhibitors (lisinopril four, cilazapril and enalapril two). Conclusions: Accordingly, the use of ATC group C agents increases with pregnancy advancement, as also indicated by our results. The usage of the most common used antihypertensive drugs, assume to be safe during pregnancy. The exact cause of these malformations cannot be positively identified because the fetus is generally not exposed to a single teratogenic factor but to a combination of such effects. Fortunately, however, clinical experience with many of these drugs taken as a necessity indicates that most are probably safe for use during pregnancy.

pregnancy, antihypertensive drugs

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