Ms. BD is a 33-year-old G2P1 female who has a history of chronic HTN. She was diagnosed with this in the interim since her first pregnancy, and she has been well controlled with Prinizide 12.5/20 PO BID. Her period, usually very regular, was 5 days late. She performed a home pregnancy test which was positive. She states she feel “OK” but is concerned about both her HTN and her developing fetus. She has no other medical problems, symptoms, or concerns.
Assessment: Physical examination is unremarkable. Her BP is 128/68 and her pulse is 74. Her urine human chorionic gonadotropin (HCG) is positive. Her potassium is 4.2, blood urea nitrogen (BUN) is 14, and creatinine is 0.6. Alanine aminotransferase (ALT) is 29. White blood cells (WBCs) are 6.5, hemoglobin (Hgb) is 12.8, hematocrit (Hct) is 39, and platelets are 330,000.
Given that BD is pregnant, would there be any contraindications in pharmacologically with treating her hypertension?
Are there any medications that are safe in treating hypertension with pregnancy?
If there changes that are needed, what medications would you suggest?
Why is it important to assess the above laboratory values?