Medical prevention of pre-eclampsia.

There is no clear evidence that any of the antihypertensive drugs available can defer or prevent the occurrence of proteinuric pre-eclampsia or associated problems such as fetal growth retardation or perinatal death. When antihypertensive treatment is indicated, there seems to be no reason to prefer any of the tested beta-blockers, or to prefer labetalol to a pure beta-blocker, or indeed, to prefer beta-blockers to methyldopa. The increased maternal, fetal and infant mortality and morbidity associated with hypertension in pregnancy justify careful evaluation of the risks of the more severe forms of hypertension at an early stage in all pregnancies. A careful family and medical history are benchmarks in pregnancy surveillance, followed by meticulous monitoring of the pregnant mother in a well organized maternity health care system where high maternal compliance is necessary together with use of appropriate methods to predict hypertension early. Prophylactic treatment with medication causing least harm to the mother and fetus to prevent serious complication due to hypertension in pregnancy when increased risk is identified would be of value and further improve maternal and fetal outcome.