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Pre-eclampsia Oral Antihypertensive — FRCA Final MCQ

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EasyObstetric AnaesthesiaPre-eclampsia Oral AntihypertensiveFRCA Final

A 28-year-old woman (ASA I, 62 kg) at 28 weeks gestation is diagnosed with pre-eclampsia. Her blood pressure is 155/98 mmHg on two readings 4 hours apart, with proteinuria 2+ and no other features of severe disease. According to NICE NG133, what is the first-line oral antihypertensive for ongoing blood pressure management?

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Correct answer: B — Labetalol

NICE NG133 (2019, updated 2023) recommends oral labetalol as first-line antihypertensive for non-severe hypertension in pre-eclampsia. Nifedipine MR is second-line. Methyldopa is third-line. This differs from the acute management of severe hypertension (systolic ≥160 or diastolic ≥110) where IV labetalol is first-line. Atenolol is avoided in pregnancy due to associations with fetal growth restriction. ACE inhibitors and ARBs are absolutely contraindicated in pregnancy (teratogenic).

Reference: NICE – 2023 – NG133 Hypertension in pregnancy