According to the American Congress of Obstetricians and Gynecologists (ACOG), which of the following would be the most appropriate first-line therapy for acute treatment of hypertension in a patient with severe preeclampsia (e.g., blood pressure 190/105 mm Hg)?
In severe preeclampsia, blood pressure control is critical to prevent maternal complications such as cerebrovascular hemorrhage, congestive heart failure, cerebral edema, and myocardial infarction.
No antihypertensive therapy has been shown conclusively to alter the progression of the disease or improve perinatal outcomes. Despite the need for acute control of maternal blood pressure, drastic changes in uteroplacental perfusion pressure should be avoided since they may lead to uteroplacental insufficiency. Careful titration of drugs with a goal of acutely lowering maternal blood pressure no more than 15-20 percent from baseline is recommended. Commonly used drugs include the following:
Nifedipine is a calcium-channel blocking...