Study on Prescribing Pattern of Antihypertensives in Pregnancy at a Tertiary Care Teaching Hospital, India

Objective: To assess Prescribing Pattern of Antihypertensives In Pregnancy at A Tertiary Care Teaching Hospital, India. Methodology: The study was carried out for duration of 6 months enrolling 100 patients. Pregnant women of any age admitted in the gynecology department and willing to participate in the study were included. The prescriptions were assessed on the basis of patient details including age, category of hypertension during pregnancy and drugs prescribed. Neonatal outcome was assessed with the category of hypertension during pregnancy. Result: During the study period, data of 100 pregnant women were analyzed, out of which 22 patients were diagnosed with hypertension. The mean age of the patients was 25.2years; with a minimum age of 18 years and maximum 38 years. Among 22 hypertensive pregnant women, 53%were primigravida whereas 5% multigravida. Among the Pregnant women associated with hypertension, 13 were diagnosed as pregnancy induced hypertension, 5 were preeclampsia and 2 patients were severe eclampsia. The prescribing pattern of antihypertensives which includes both monotherapy as well as combination therapy. Severe hypertension in pregnancy is a threat to the mother and child affecting their wellbeing. We observed various hypertensive disorders, among which prevalence of pre-eclampsia was high. In the current research, prescribing pattern of antihypertensives was based on the efficacy and safety profile in pregnancy. Accordingly, labetalol and nifedipine were frequently administered to patients as monotherapy and combination therapy. Labetalol has a status of first line therapy in the treatment of hypertensive urgency. The current study has reported a major drug interaction between labetalol and diltiazem. Concurrent use of these drugs may increase the risk of bradycardia, hypotension, and AV conduction disturbances. Therefore, monitoring the cardiac function and blood pressure is essential. Drug interaction between nifedipine and fosphenytoin was observed in the current study with major severity. Co-administration of these drugs may decrease the efficacy of nifedipine. Hence these combinations must be avoided and alternate hypertensive management should be recommended. Conclusion: The present study confirms the previous findings that labetalol is an effective and safe drug for use quicker in achieving adequate in the control of blood pressure in pregnancy-induced hypertension. The low frequency of maternal and fetal side-effects along with the brilliant perinatal result in a condition typically joined by a high maternal and fetal mortality and morbidity affirms its appropriateness for use during pregnancy.