Presently I am working in a peripheral tertiary centre where about 20000 women deliver. We get many mother of hypertension. We usually prescribe them nifedipine tablet 10 mg po tid. Most of the mother undergo cesarean section and our result is very promising. We also pescribe low dose Magnesium Sulphate. But we feel difficulties when managing post cesarean hypertension. We usually do not prescribe Labetalol injection both preoperatively or postoperatively. I want an evidenced based as well as practical protocol. Nifedipine and lowdose MgSO4 is safe in our centre depending upon the BMI of our pregnant mothers.
In my institution, most of the women are primigravida between 18 to 22 years of age and average built. Spinal anesthesia with bupivacine is practiced. Most of the cases are of PIH. We do not use injectable anti hypertensive due to lack of ITU facility and manpower.
Thank you for the reply. The article is touching the overall topic superficially. Immediate 48 hours of CS, many patient have BP of more than 180/120. In this situation, what will be the best medication (Obviously, injectable)?
Thank you for the reply. I agree with you, sir.
In the world literature, there are several articles and guideline of hypertension in pregnancy. The time period immediate after CS is neglected. Expert opinion is that antihypertensive therapy should be upon the experience of obstetrician. We do what you told above. I am observing that after several day [except you] no one touching this question. It is very important to manage pregnant women accordingly without terminating the pregnancy early.
Dear Sir,
I am working in a warm country. It is my experience and observation that is very interesting. During winter season when suddenly temperature falls, we get more eclamptic mothers from rural area. when there is heavy rainfall, we get more eclamptic mothers. There are some research articles describing this. This could be due to vasospasm or water restriction. In western country this has been explained as less sunlight exposure.