Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
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 Ask Dr. Greenfield
Concerned about Pre-eclampsia in Future Pregnancies | | | QUESTION | | | Dear Dr. Greenfield,
I had pre-eclampsia with my first pregnancy, which started during my 34th week. Since then, my blood pressure has not improved and my doctor recently put me on tenormin (I am already taking synthroid). I want to have a second child but I am very scared. My doctor told me that tenormin is safe for pregnancy, but the information on the printout says it is not. I was wondering if you had any information about this. I know that this may be hard to determine and that every pregnancy is different. I am just trying to decide what to do.— MisBink in Stormville NY | | | ANSWER |
October 19, 2001 | | | Dear MisBink,
While we usually think of pre-eclampsia as a problem of first pregnancies, it sometimes occurs as a complication of underlying high blood pressure (chronic hypertension). When that is the case, pre-eclampsia does have a tendency to recur in subsequent gestations. Taking anti-hypertensive medications in pregnancy doesn't totally prevent pregnancy complications. Since it's best to wait a minimum of one year between babies, you have at least a few more months to think it through and get yourself in the best possible medical condition. If you are overweight, weight loss may help to control your blood pressure without drugs.
There is some question about the use of atenolol (Tenormin) in pregnancy. Atenolol hasn't been proven safe in the first trimester, and may be associated with some types of birth defects. In addition there is mounting evidence that it affects fetal growth more than some other anti-hypertensive medications do, by causing restriction of blood flow to the fetus. Even so, there are situations when it may be the best choice for treating a mother-to-be's medical condition.
If you have questions about your doctor's recommendations, a second opinion from a maternal-fetal medicine specialist (high risk obstetrician) may help you to decide your best course of action. Take care.— by Marjorie Greenfield, M.D. |
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