DIAZOXIDE, a nondiuretic thiazide, when injected intravenously (IV) is a potent arteriolar dilator effective in the treatment of severe hypertension associated with pregnancy.1,2 Animal studies have shown that diazoxide crosses the placenta, causing fetal hyperglycemia3,4 and destruction of pancreatic islet cells.5 An infant experienced severe persistent postnatal hyperglycemia after in utero exposure to diazoxide.
Report of a Case
A 31-year-old woman, gravida 1, para 0, noted to have proteinuria (2+) and blood pressure (BP) of 130/90 mm Hg at approximately 30 weeks' gestation, was hospitalized at 33 weeks with complaints of abdominal pain. A BP of 200/130 mm Hg, with 3+ reflexes, ankle edema, and proteinuria (3+) were present. Mild uterine contractions ensued, with BP to 240/140 mm Hg. The mother was initially treated with intramuscular magnesium sulfate and hydralazine hydrochloride, with reduction in BP to 194/130 mm Hg. Approximately 2 1/2 hours before delivery, furosemide, 40
Milsap RL, Auld PAM. Neonatal Hyperglycemia Following Maternal Diazoxide Administration. JAMA. 1980;243(2):144-145. doi:10.1001/jama.1980.03300280042026