PLAB Question 18

A young woman develops mild hypertension that first develops during pregnancy.

Which of the treatment strategies below is the most preferred first-line therapy for her:

a) immediate delivery
b) intravenous Hydralazine
c) alpha-blocker
d) Labetolol
e) change current treatment immediately
f) diuretic
g) Methyldopa
h) calcium antagonist
i) angiotensin-converting enzyme inhibitors
j) angiotensin II receptor antagonist

ANSWER
The correct answer is G



Explanation
Methyldopa is preferred as first-line therapy by many clinicians when hypertension develops during pregnancy. If it is not well tolerated, alternatives are available.

Use of a diuretic, a mainstay of hypertension management, is considered controversial in pregnant patients but the primary concern is theoretical. Diuretics can be used if warranted. Experience with calcium antagonists is limited.