Pharmacotherapy of Hypertension in Pregnancy in a Secondary Hospital in South West Nigeria

Abstract

Hypertension in pregnancy has damaging effects on the blood vessels of the expectant mother as well as the blood supply involving the placenta exchange of oxygen and nutrition from mother to baby. A retrospective study of five years of the management of hypertension in pregnancy at Adeoyo Maternity Hospital, Ibadan was made. Its primary purpose was to assess the rational pharmacotherapeutic approach to the management of hypertension in pregnancy at the secondary hospital during the period of 5 years (2003-2007). Three hundred 300 randomly selected case notes of pregnant hypertensive patients from the medical records within age bracket of 15-40 years admitted into the antenatal ward of Adeoyo Maternity Hospital, Ibadan were thoroughly studied. Gestational hypertension was 240 (80.0%), pre-eclampsia was thirty four (34) (11.3%), while eclampsia was twenty six (26) (8.7%). Methyldopa was the most frequently administered drug as it was administered to 43.0 ± 4.4 patients, nifedipine was administered to 33.6 ± 8.6 patients, while hydralazine was administered to 16.4±2.0 patients. F-Tests (P<0.05) indicated significant differences between the three drugs, with methyldopa being the most significantly used antihypertensive following Fisher’s least significant differences test (LSD_0.05). Although not statistically significant (P>0.05), patients’ response to methyldopa appeared better than any of the other two drugs with comparatively lower number of 2.1±0.4, 4.5±0.7, 3.3±2.1, 3.1±0.6 and 3.6+0.5 days spent on admission over the five year period. Patients on hydralazine spent 2.4±0.5, 3.4 ± 0.8, 3.5±0.8, 3.8±1.2 and 4.3±1.4 days and patients on nifedipine spent 3.0±0.4, 3.7±0.4, 3.4±0.4, 2.5+0.4 and 4.2±0.6 days. It was discovered that patients on methyldopa spent the least number of days on admission. This was followed by patients on hydralazine and nifedipine who spent few more days respectively than those on methyldopa. Optional therapy for gestational hypertension requires early detection, especially during antenatal clinic. It also requires utilization of appropriate pharmacotherapeutic and non-pharmacotherapeutic measures such as bed rest. The findings from this study will serve a beneficial purpose in the long term management of hypertension in pregnancy.

Keywords: pregnancy, gestational hypertension, pharmacotherapy, antihypertensive

Nigerian Journal of Pharmaceutical Research, Vol. 8 No 1, pp. 1-11