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Hypertension in Pregnancy — ESENeph MCQ

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EasyPregnancy & RenalHypertension in PregnancyESENeph

A 30-year-old woman at 14 weeks gestation is found to have a BP of 152/96 mmHg on two occasions. She has CKD G3aA2 due to reflux nephropathy. uACR is 12 mg/mmol. She is currently on no antihypertensives. What is the most appropriate first-line agent?

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Correct answer: C — Labetalol

ACE inhibitors and ARBs are contraindicated in pregnancy (teratogenic). NICE CG107 (Hypertension in Pregnancy, updated 2023) recommends Labetalol as first-line for hypertension in pregnancy unless contraindicated (e.g. asthma). Nifedipine (not amlodipine, which lacks the same evidence base) is second-line. Methyldopa is an alternative but is now considered less well tolerated.

Reference: https://guidelines.ukkidney.org