Is a pregnant woman allowed to take antihypertensive medicines and which ones Which particular hypertensive problem exists for pregnant women with Type DM

All antihypertensive medicines should be discontinued if hypertension is under control (< 130/80 mmHg) with restriction of table-salt and proper nutrition. These levels should be maintained during the whole course of the pregnancy.

ACE inhibitors and inhibitors of angiotensin receptors are contraindi-cated in pregnancy due to a nephrotoxic action on the foetus and should be discontinued before a woman becomes pregnant. If during the course of the pregnancy hypertension develops, rest is recommended and frequently prescription of various medicines is required, such as methyldopa, labe-talol, clonidine or hydralazine or even beta-blockers, with the provision that they can mask the early symptoms of hypoglycaemia.

According to some studies women with Type 1 DM have more frequent rates of pre-eclampsia than the general population (16 versus 5 percent) and this rate is thought to surpass 50 percent when nephropathy coexists. Women with long-standing DM under poor control, who are on their first pregnancy and have proteinuria > 190 mg/24 hours or have nephropathy are at the highest risk.

The 130/80 mmHg blood pressure target refers to the duration of pregnancy, as well as before it.

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