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MCQ – 52019

Question

According to current obstetric guidelines, which drug is preferred for long-term management of chronic hypertension during pregnancy?

A. Extended-release nifedipine
B.

Hydralazine

C.

Sodium nitroprusside

D.

Furosemide

Show Answer

Correct Answer » A

Explanation

Chronic hypertension in pregnancy requires antihypertensive therapy that is:

  • Safe for both mother and fetus
  • Effective for prolonged blood pressure control
  • Suitable for outpatient long-term use

Current guidelines commonly prefer:

  • Labetalol
  • Extended-release nifedipine

Among the given options, extended-release nifedipine is the best choice.

A. Extended-release nifedipine 

Nifedipine is a calcium channel blocker widely used for chronic hypertension in pregnancy.

Advantages:

  • Effective long-term BP control
  • Once-daily extended-release preparation
  • Better patient compliance
  • Safe in pregnancy
  • Fewer CNS side effects than methyldopa

Why Other Options Are Incorrect

B. Hydralazine 

  • Mainly used for:
    • Acute severe hypertension
    • Hypertensive emergency in pregnancy
  • Not preferred for long-term outpatient therapy.

C. Sodium nitroprusside 

  • Reserved for refractory hypertensive emergencies.
  • Risk of fetal cyanide toxicity.
  • Contraindicated for routine long-term use in pregnancy.

D. Furosemide 

  • Diuretics are not first-line drugs for chronic hypertension in pregnancy.
  • May reduce placental perfusion. 
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