PP.24.03] EFFECT OF NEBIVOLOL TO PROTECT INCIDENCE OF ECLAMPSIA AND PREECLAMPSIA DURING PREGNANCY IN WOMEN AFTER INVITRO FERTILIZATION

Abstract

Objective: To investigate the effect of treatment with Nebolol in pregnant women with chronic hypertension (CH) after invitro fertilization. Design and method: We studied 655 IVF pregnant women with arterial hypertension (mean age 37 ± 16 y). All patients, divided on two groups, regarding the level of BP from AMBP, were analyzed at baseline before starting therapy in the first trimester and second and third trimester too. The group with mild AH received 2.5 mg Nebibolol daily and group with moderate and severe AH – 5/10 mg. We divided the patients into 3 groups with respect to their LV diastolic function (normal – 220 patients, impaired LV relaxation – 335 patients and impaired relaxation with reduced compliance and elevation of LV end-diastolic pressure – 100 patients). Results: After therapy BP decreased by 23.3 ± 13.2/11.6 ± 6.4 to 131.6 ± 5.6/76.0 ± 4.6 mmHg (p < 0.0001). Blood pressure targets were reached by 88.0% of patients. Changes in BP were 19.8 ± 8.3/9.7 ± 7.2 mmHg for grade 1, 20.3 ± 10.5/15.6 ± 9.6 mmHg for grade 2, and 35.3 ± 16.2/19.8 ± 12.2 mmHg for grade 3 patients (p < 0.0001). The ambulatory blood pressure monitoring 24-h mean blood pressure decreased from 148.6 ± 12.7/78.1 ± 13.6 to 123.7 ± 6.4/77.8 ± 6.5 mmHg (p < 0.0001). Diastolic blood pressure at 36. week was significantly lower from baseline. (p = 0.001) During follow up we found improvement of systolic BP more significant in the group with severe AH and treated with higher dose nebivolol 5/10 (p = 0.01). During the treatment the incidence of preeclampsia were very low in group with Nebivolol (1.3%) compare with women on standard methyldopa therapy (9%). Conclusions: Nebivolol is effectively and safely administered to a large population hypertensive pregnant women, who had not reached target BP values during pregnancy and prevent the incidence with eclampsia and preeclampsia