Adrenergic Beta-Receptor Blockers in Hypertension of Pregnancy

This is a study of the selective beta-blocking agent metoprolol in combination with either thiazide or hydralazine in 184 hypertensive gravidae. The effects on the mother and the fetus are compared with those of 97 hypertensive gravidae treated with a combination of hydralazine and a thiazide. The combination of metoprolol and hydralazine seems to be the most favourable one judged by both maternal well-being, fetal intrauterine growth, ten-minute Apgar score and perinatal mortality. At birth the concentration of metoprolol shows a ratio of 1:1 between maternal plasma and umbilical plasma and furthermore the ratio between maternal plasma and breast milk is 1:4. The newborns of mothers on beta-blocking therapy did not differ from those of mothers on hydralazine regarding heart rate, plasma glucose or plasma bilirubin. These data indicate that fetal danger from selective beta-blocking agents during pregnancy may have been overestimated.