Obstetrics & Gynaecology — UKMLA MCQ

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HardObstetrics & GynaecologyUKMLA

At 31 weeks, a pregnant woman has persistent blood pressure 152/98 mmHg and proteinuria. She has no asthma, bradycardia or other contraindication to beta blockade. Which oral antihypertensive should be considered first?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Labetalol

The best answer is “Labetalol”. NICE advises considering labetalol for hypertension in pregnancy. Nifedipine is considered when labetalol is unsuitable, and methyldopa when neither is suitable. ACE inhibitors and angiotensin-receptor blockers are avoided because of fetal toxicity, while spironolactone is not routine treatment. The woman also needs assessment and surveillance for pre-eclampsia severity and fetal wellbeing.

Reference: NICE NG133, Hypertension in pregnancy: https://www.nice.org.uk/guidance/ng133/chapter/Recommendations