Gallery E D, Saunders D M, Hunyor S N, Györy A Z
Br Med J. 1979 Jun 16;1(6178):1591-4. doi: 10.1136/bmj.1.6178.1591.
Fifty-three pregnant women with moderately severe hypertension were randomly allocated to treatment with methyldopa or oxprenolol. There were no significant differences between the groups in age, height, weight, parity, or stage of gestation at the start of treatment. The outcome of pregnancy was better in the group treated with oxprenolol, with greater maternal plasma volume expansion and placental and fetal growth. No intrauterine deaths occurred in either group, and antepartum fetal distress, detected by oxytocin challenge testing, was evident in only one patient, who received methyldopa. This infant, and one other in the methyldopa group, died in the neonatal period. No neonatal deaths occurred in the oxprenolol-treated group. Even in this small number of patients these results were considerably better than those in untreated women with hypertension of similar severity. Apgar scores in both groups were equivalent at birth, while blood sugar concentrations were higher in the oxprenolol group. Oxprenolol appears to be safe and effective in controlling hypertension during pregnancy. There was no evidence of harmful effects on the fetus, and oxprenolol may offer a selective advantage over methyldopa for fetal growth and wellbeing in utero.
53名中度严重高血压孕妇被随机分配接受甲基多巴或氧烯洛尔治疗。治疗开始时，两组在年龄、身高、体重、产次或妊娠阶段方面无显著差异。氧烯洛尔治疗组的妊娠结局更好，母体血浆量增加更多，胎盘和胎儿生长情况更佳。两组均未发生宫内死亡，通过催产素激惹试验检测到的产前胎儿窘迫仅在1名接受甲基多巴治疗的患者中出现。该婴儿以及甲基多巴组的另1名婴儿在新生儿期死亡。氧烯洛尔治疗组未发生新生儿死亡。即使在这少数患者中，这些结果也明显优于未治疗的类似严重程度高血压女性。两组出生时阿氏评分相当，而氧烯洛尔组血糖浓度更高。氧烯洛尔在控制孕期高血压方面似乎安全有效。没有证据表明对胎儿有有害影响，并且在胎儿宫内生长和健康方面，氧烯洛尔可能比甲基多巴具有选择性优势。
