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August 6, 1982

β-Blockers may have role in preeclampsia

JAMA. 1982;248(5):516-518. doi:10.1001/jama.1982.03330050006004

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American physicians have been reluctant to treat hypertension during pregnancy with β-blockers because of isolated case reports of growth retardation and respiratory distress in the newborns. However, the first placebo-controlled investigation of the use of a β-blocker in pregnancy-associated hypertension shows no adverse effects on fetal growth or neonatal well being

Traditionally, obstetrician-gynecologists prescribe bedrest and sedatives when a pregnant woman's diastolic pressure exceeds 90 mm Hg. If hypertension persists, methyldopa is the most popular and thoroughly studied therapy. The use of β-blockers, which has been effective in other countries, is still controversial in the United States, where there are no controlled studies of the drugs' use in this condition and no large series of patients so treated.

Peter C. Rubin, MD, of Stobhill General Hospital in Glasgow, conducted a prospective, double-blind, randomized trial involving 120 pregnant women in whom hypertension developed in the last trimester. When systolic pressure reached