It is known that methyldopa application could decrease maternal heart rate variability. Should we change our practice?
Actually, I mean maternal. Methyldopa acts negatively on total power and not predominantly on LF (sympathetic activity).
Every hypotensive drugs including methldopa effect on fetal well-being;please check my Home Page http://www.p-lap.org/ Shigehiko mizutani
Hello Igor. Labetalol is the first line antihypertensive agent for hypertension in pregnancy in the UK, especially where acute hypertensive crisis arises. See http://www.ncbi.nlm.nih.gov/books/NBK62652/pdf/TOC.pdf AND http://www.nice.org.uk/nicemedia/live/13098/50418/50418.pdf
Thank you, Carol. I will provide my colleagues with this information and try it next weеk in my investigations.
Administration of conventional antihypertensive agents including methyldopa to severe preeclamsia patients is beneficial to fetus?
It is well known that conventional antihypertensive agents are not effective for severe preeclamsia patients. However intra-uterine fetal death or interruption of pregnancy by Cesarean section results in the decrease of blood pressure of severe preeclamsia patients. Therefore obstetricians decide Cesarean section irrespective of pregnancy weeks even if fetus is premature.
Fetal oxygen is supplied from placenta. It is well known that fetus is exposed to hypoxia and fetus increases angiotensin and vasopressin, both of them is powerful vasoactive peptide hormone, in parallel with hypoxia in preeclampsia, suggesting that fetus makes an effort to increase blood pressure in the feto-placental unit. Placenta is essential organ of feto-placental unit. Placenta is attached maternal site to uterus and fetal oxygen is supplied from maternal blood, the space between placenta and uterus (so called retro-placental blood pool).
Fetal blood pressure is much lower than mother in addition blood pressure of placental peripheral circulation is much more low than mother.
When conventional antihypertensive agents are administered to preeclamsia patients, these agents easily move to the feto-placental unit and then they block the fetal action to hypoxia, namely an effort to increase blood pressure.
If obstetricians consider the physiology of pregnancy above mentioned, they hesitate to use conventional antihypertensive agents to severe preeclamsia patients.
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please check my Home Page http://www.p-lap.org/ Shigehiko mizutani
So we are to find out the most safe way to optimize maternal cenral hemodynamics and fetal ergo-, trophotrophic ability in preeclamptic patients. I mean that both maternal and fetal HRV investigation using non-invasive ECG method is a prospective instrument to create the new theraputic strategy.
Would you please kindly read the natural hormonal therapy for preeclampsia patients and preterm labor related to the most safe way for treatment of preeclampsia in my NPO home page :http://www.p-lap org /
Dear Sir! I am very impressed with your experience. I will try to obtain more data about possible application of sexual steroids drugs in preeclamptic patients. Undoubtedly the investigation in the real clinical situation is rather prospective.
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