Alicia Mabel Lapidus

Two-dimensional and M-mode echocardiographic findings in hypertensive pregnant women

Two-dimensional and M-mode echocardiograms were obtained during the thirty-second week of gestation from 69 women classified as follows: group I, 22 normotensive primigravid women; group II, 16 primigravid women with pregnancy-induced hypertension; group III, 21 percent women with essential hypertension; and group IV, 10 normotensive nonpregnant control subjects. Systolic, diastolic, and mean arterial pressures were higher in groups II and III than in groups I and IV (p less than 0.001). Echocardiographic dimensions were significantly increased in group III compared with the other groups (p less than 0.01). No significant differences were observed among the other groups in the echocardiographic parameters or in the indices of ventricular performance studied. In echocardiographic studies, chronic hypertensive pregnant women are distinguished from patients with pregnancy-induced hypertension because the former have ventricular hypertrophy resulting from the pressure overload exerted for a long period of time. Our patients with essential hypertension experienced no changes in left ventricular performance because of the early stage of their hypertensive disease.

Ketanserin versus alpha-methyldopa in the treatment of hypertension during pregnancy: a preliminary report.

The antihypertensive efficacy of acute treatment with the serotonin receptor antagonist, ketanserin, in women with preeclampsia has been recently documented. The purpose of this study was to determine the safety and efficacy of chronic ketanserin treatment in a group of 20 hypertensive pregnant women: 10 received daily oral doses of ketanserin (20-80 mg), and 10 were treated with oral alpha-methyldopa (500-2000 mg). This study includes (a) patients with a sustained elevation of systolic blood pressure higher than 159 mm Hg and/or diastolic blood pressure higher than 99 mm Hg at bed rest, and (b) hypertensive patients with systolic blood pressure higher than 140 mm Hg or diastolic blood pressure higher than 90 mm Hg with superimposed symptoms such as headaches, stomach aches, and neurological disturbances. A significant and comparable decrease in blood pressure was noted in both groups, in relation with pretreatment levels; no adverse affects were observed in mother or fetus from the ketanserin and alpha-methyldopa groups.

Renal response to an acute protein challenge in pregnant women with borderline hypertension

Background:  The renal reserve (RR), assessed after an oral protein challenge or the intravenous administration of amino acids, is still present in healthy pregnant women (NP), although resting glomerular filtration rate (GFR) and renal plasma flow (RPF) increase progressively throughout normal gestation. No studies have addressed this issue in hypertensive gravidas; the aim of this trial was to evaluate renal response to an acute protein load (PL) in NP and pregnant women with borderline hypertension (HP).

Effectiveness of Antihypertensive Drugs in the Treatment of Hypertension in Pregnancy

The purpose of this open, prospective, randomized, comparative study was to examine the effectiveness of atenolol, a cardioselective beta1 blocker, alphamethyldopa, an alpha-adrenergic antagonist, and ketanserin, a serotonin receptor antagonist, in the treatment of 90 patients (N–30 each) with severe chronic hypertension (ChH) during pregnancy or severe pregnancy-induced hypertension, with or without proteinuria in either case.Arterial blood pressure (BP) for each drug group was analyzed at the onset of treatment, weekly for three weeks, and at the end of pregnancy. After one week of treatment a significant drop in BP was observed in the three groups of patients. Thereafter BP remained stable until the end of gestation, when a slight increase in BP was observed, especially in the group of patients treated with ketanserin.No significant difference was observed between the groups in mean birthweight and perinatal morbidity and mortality. No adverse effects from the drugs on the fetus or newborn were observe...