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February 1990

Neonatal Nasal Obstruction Associated With Methyldopa Treatment During Pregnancy

Author Affiliations

Children's Hospital of Winnipeg 840 Sherbrook St Winnipeg, Manitoba R3A 1S1 Canada
Pharmacy Services Children's Hospital of Winnipeg
Department of Pediatrics Children's Hospital of Winnipeg
Dr Le Gras is now with The Hospital for Sick Children, Toronto, Canada.

Am J Dis Child. 1990;144(2):143-144. doi:10.1001/archpedi.1990.02150260021013

Sir.—Methyldopa is used frequently in the long-term management of hypertension in pregnancy because of its documented effectiveness and relative lack of fetal toxicity.1,2 Although not reported in neonates, nasal congestion is a known side effect of methyldopa in 1% to 3% of adults and children receiving long-term therapy.3 We report an association between maternal administration of methyldopa and neonatal nasal obstruction.

Patient Reports.—Patient 1.—A 38-year-old gravida 3, para 1, aborta 1 woman underwent an elective cesarean section at 39 weeks' gestation because of frank breech fetal position, maternal hypertension, and advanced maternal age. She was treated with methyldopa (250 mg orally twice a day) since the eighth week of gestation. At delivery, a loop of cord was noted around the neonate's neck and there was moderate difficulty in delivering the head. The Apgar scores were 3,8, and 9 at 1,5, and 10 minutes, respectively, and

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