Twenty-five patients whose pregnancies were complicated by chronic
hypertension were entered in a double-blind study and randomly allocated to treatment with
methyldopa (
Aldomet) or placebo. Thirteen patients were in the treatment group and 12 in the placebo group. The two groups showed no significant difference in demographic and pretreatment laboratory profiles.
Methyldopa-treated patients registering in the first trimester had a significant reduction in the mean arterial pressure (MAP) during the second and third trimesters (P less than 0.025). No significant differences in
birth weight (BW), ponderal index (PI) were found when results were corrected for gestational age (GA), race, and sex. The mean GA was significantly prolonged in the
methyldopa-treated group by 10.3 days (P less than 0.05). The frequency of superimposed
pre-eclampsia was similar in both groups (33.3% vs. 38.4%). However, 75% of the superimposed
pre-eclampsia occurred antepartum in the placebo group, while 80% of the
methyldopa-treated group developed superimposed
pre-eclampsia intrapartum. The results of this small study suggest that the treatment of
hypertension in pregnancy may reduce MAP and possibly delay the occurrence of superimposed
pre-eclampsia and thus afford a prolongation of the pregnancy.