[Treatment of severe hypertension in pregnancy].

Treatment of severe hypertension in pregnancy, particularly in preeclampsia and eclampsia, is a great challenge to the obstetrician and requires prompt and expert management. Application of antihypertensive agents is limited during pregnancy because of possible side effects, particularly impairment of the fetal state. The following survey present a detailed discussion on the substances suitable for treating hypertensive emergencies in pregnancy and their side effects. Despite restricted therapeutic possibilities, safe and successful treatment of severe hypertension during pregnancy can best be performed with dihydralazine and diazoxide, which achieve their effect by reducing the peripheral vascular resistance. If the blood pressure cannot be adequately reduced with these substances, treatment can be continued with sodium nitroprusside. A critical discussion is presented in this connection on drugs such as clonidine and reserpine, which reduce pressure largely by central mechanisms and should no longer be applied in pregnant patients because of serious disadvantages. Consideration is also given to the special clinical problems associated with pheochromocytomas, and a concluding discussion deals with the perspectives of antihypertensive therapy in pregnancy.