Professional and Linguistic Assessments Board (PLAB) Practice Exam

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What is the recommended treatment for a pregnant patient with hypertension?

Amlodipine
Methyldopa
Lisinopril
Hydrochlorothiazide

The correct answer is: Methyldopa

The recommended treatment for a pregnant patient with hypertension is Methyldopa. This medication has a long history of use in managing hypertension during pregnancy and is considered safe for both the mother and the fetus. Methyldopa acts by stimulating central alpha-2 adrenergic receptors, which leads to a reduction in sympathetic outflow and a subsequent decrease in blood pressure. Its proven safety profile and effectiveness make it a first-line choice for treating hypertension in pregnant women. Other medications used for hypertension in non-pregnant patients may carry risks during pregnancy. For instance, Amlodipine is a calcium channel blocker and while it may be used with caution, it is not typically the first choice. Lisinopril, an ACE inhibitor, is contraindicated in pregnancy due to potential teratogenic effects and risks to fetal development. Hydrochlorothiazide, a thiazide diuretic, is also not commonly recommended as a first-line treatment due to limited data on its safety in pregnancy and potential issues with volume contraction in the mother. Therefore, Methyldopa remains the preferred and safest option for managing hypertension in pregnant patients.