Introduction
Beta blockers are important and frequently prescribed drugs. They are used to treat arterial hypertension, heart failure and coronary heart disease. There is a relative contraindication for beta blockers in pregnancy.
This means that they may only be used under a strict risk-benefit assessment. Nevertheless, there are also reasons for the justified use of beta blockers during pregnancy. The best experience has been made with the active substance metoprolol.
Beta-blockers represent a therapeutic approach, especially in cases of gestational hypertension. In the following article interesting aspects concerning the use of beta blockers in pregnancy will be explained in more detail. In addition, important questions concerning the tolerability of the active substances for mother and child are answered. Frequent clinical pictures that require a therapy with a beta blocker are explained in detail, especially with regard to drug therapy.
Indications for a beta blocker in pregnancy
For beta-blockers in general, there has been a high level of experience for many years. They are frequently used active ingredients that play an important role in the therapy of widespread diseases. These include in particular high blood pressure, heart failure and coronary heart disease.
But what is the situation during pregnancy? What are the indications for the use of beta-blockers in pregnancy? The main reason for using beta-blockers in pregnancy is if you have a hypertensive pregnancy disorder – i.e. high blood pressure.
Treatment to lower blood pressure must always take into account the well-being of both the mother and the unborn child. Blood pressure values that are systolically above 160 mmHg or diastolically above 110 mmHg should be reduced by medication. In these cases, beta-blockers are a legitimate way to lower blood pressure.
However, they are usually only used when the drug of choice – alpha-methyldopa – must not be used. The beta-blocker of choice is then Metoprolol. Beta-blockers are established and effective drugs in the prophylaxis of migraine.
This means that they are used to prevent migraine attacks. Beta-blockers can also be used with restrictions during pregnancy. Only metoprolol is recommended.
Unfortunately, there are hardly any controlled studies on this topic. However, about 50 to 80% report an improvement in migraines during pregnancy, so prophylaxis is not always necessary. If it does, there is the possibility of taking metoprolol.
Alternatively, magnesium, but also non-drug options such as relaxation exercises are possible. A high pulse rate is not in itself a reason for drug therapy – not even during pregnancy. Often a high pulse is due to nervousness, stress or even other – non-cardiac – causes, such as hyperthyroidism.
Therefore, the cause of the high pulse should first be clarified before a beta blocker is used to lower the pulse. Another adapted therapy may be necessary, for example against hyperthyroidism or cardiac arrhythmia. However, relaxation exercises and stress reduction are often sufficient.
The heart rate also increases during pregnancy as part of the body’s natural adaptation mechanisms and may therefore be increased to a certain extent. In principle, a beta-blocker such as metoprolol can be used, but the benefit and usefulness of the therapy must first be checked. Kidney congestion is a not uncommon complication during pregnancy and can occur due to the altered space conditions in the abdomen, resulting in urinary retention.
It often goes unnoticed and causes no symptoms. In some cases, however, it can lead to impairment of the mother, which can be not only painful but also dangerous. In particular, an infection during urinary retention can lead to complications.
Therapy is therefore necessary in some cases. If there is a pronounced obstruction of the urinary tract, a ureteral splint can be used to restore the flow of urine. Antibiotics are used at an early stage if an infection is suspected in the case of kidney congestion. In some cases beta-blockers, especially metoprolol, are also used. However, the benefit is controversial.
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