Pharmacological management of severe pre-eclampsia

(Very) High blood pressure in pre-eclamptic women poses a serious risk of acute cerebrovascular complications in these women, necessitating the use of antihypertensive treatment in pre-eclampsia. In this review, the different antihypertensive drugs used in the management of pre-eclampsia are discussed with a focus on efficacy and maternal and neonatal safety. The characteristics of each drug are summarised, including placental transfer, and comparisons between antihypertensive drugs are shown, based on recent publications. Special emphasis is given on newer developments including treatment with ketanserin or nicardipine. Especially nicardipine seems to be a potent drug in the treatment of pre-eclampsia, but comparative trials are needed.

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