Hypertensive women are pregnant, how should antihypertensive drugs be taken? Clear up the article

For many women, pregnancy is a long and difficult process, especially if there are underlying diseases. Among them, cardiovascular disease is the most common cause of maternal indirect death, affecting 1% ~ 2% of pregnant women. < / P > < p > What are the key points in drug selection for pregnant women with cardiovascular disease? How to better protect the fetus and mother? Take a look at the sharing of Haibao pharmacists today ~ < / P > < p > with the increase of childbearing age, there are more women with cardiovascular risk factors, which also leads to the increasing burden of cardiovascular disease during pregnancy. However, for women with underlying diseases and risk factors, these changes may expose unknown risks or aggravate the existing abnormal hemodynamics. In the early stage of pregnancy, the quality of red blood cells increased. Estrogen activates renin * angiotensin aldosterone system, increasing water and sodium retention. Disproportionate volume increase leads to hemodilution, leading to physiological anemia during pregnancy. In order to adapt to the increase of body fluid, vasodilation and vascular remodeling occur with the decrease of systemic and pulmonary vascular resistance. In the second trimester of pregnancy, the decrease of systemic vascular resistance by 30% to 50% comes from the value before pregnancy, and then increases slightly in the third trimester. < p > < p > in the past, the pllr label divided the drugs used in pregnancy and lactation into a, B, C, D and X. in 2015, FDA updated the pllr label, requiring the label to describe in detail the risks and benefits of using drugs during pregnancy and lactation to replace the original simple drug classification of a, B, C, D and X. < / P > < p > b: animal tests showed no harm to the fetus or mild side effects, but there was no pregnant women control test, or the side effects were uncertain < / P > < p > C: animal tests confirmed that there were adverse reactions to the fetus, but there was no available data in pregnant women, only when the advantages and disadvantages to the fetus outweighed the disadvantages, < / P > < p > D: there was positive evidence of harm to human fetus, only Some CCB may cause premature maturity, intrauterine growth retardation, fetal bradycardia, and neonatal epilepsy if used in late pregnancy. Nifedipine is recommended for the second and third trimester of pregnancy. < / P > < p > is safe, but it is not commonly used at present. It may not be as effective as using b-blockers or CCB now. The advantages do not require any dose adjustment during pregnancy. It is not suitable to use and increase postpartum depression after delivery. < / P > < p > through the placenta, early pregnancy risk of embryonic disease, central nervous system abnormalities. Warfarin & gt; 5mg should be replaced with heparin or low molecular weight heparin in the first trimester of pregnancy. < / P > < p > back to title, how to choose antihypertensive drugs for pregnant women? ACEI / ARB should be strictly avoided. Other antihypertensive drugs can be selected under the guidance of doctors. The cardiovascular drugs that should be strictly avoided in pregnant women are ACEI / ARB, endothelin receptor antagonist, warfarin and statins. < / P > < p > for the special population such as pregnancy and lactation, the safety of mother and child is equally important! In the medication management of pregnant and lactating patients, medical workers should give appropriate suggestions from the professional point of view. Luanban