and Labetalol are well known for their use in Gestational Hypertension. Administration of ACE inhibitors during the second
and third trimesters are absolutely contraindicated as it can result in a number of fetal adverse effects, including growth retardation, renal
failure, persistent patent ductus arteriosus, respiratory distress syndrome, fetal hypotensive syndrome, and prepartum death.
4 other drugs which may be used in patients who are unresponsive to Hydralazine,
Methyldopa and Labetolol are
1. Diazoxide, but should be watched due to interference with glucose metabolism.
2. Intravenous isradipine, but data is not widely available on it.
3. Sodium nitroprusside should be used only as a last resort - as it may have
some adverse effects on the fetus.
4. Short-acting nifedipine (oral/sublingual) has been reported to be effective in the
acute treatment of severe hypertension in pregnancy, but should be used with caution as short-acting nifedipine may
be associated with maternal hypotension.