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Diuretics

Use of diuretics during pregnancy

Mosa'b Al-Balas, RPh, Pina Bozzo and Adrienne Einarson, RN

January 2009

ABSTRACT

QUESTION

Several of my pregnant patients use diuretics for hypertension. I have heard that diuretics cannot be used in pregnancy because of the reduction of plasma volume and the potential for decreasing placental perfusion, as well as a possible diabetogenic effect.

ANSWER

Many studies-including a meta-analysis of almost 7000 neonates exposed to diuretics during pregnancy-did not find an increased risk of adverse effects, such as birth defects, fetal growth restriction, thrombocytopenia, or diabetes, among neonates exposed to diuretics in utero.

QUESTION

Quelques-unes de mes patientes prennent des diurétiques pour l’hypertension. J’ai entendu dire qu’il ne fallait pas prendre de diurétiques durant la grossesse en raison de la réduction du volume plasmatique et de la possibilité de réduction de la perfusion placentaire, sans compter un effet diabétogène possible.

RÉPONSE

De nombreuses études, dont une méta-analyse portant sur près de 7 000 nouveau-nés exposés aux diurétiques durant la grossesse, n’ont trouvé aucune augmentation du risque d’effets indésirables, comme des anomalies à la naissance, une réduction de la croissance du fœtus, la thrombocytopénie ou le diabète, chez les nouveau-nés exposés aux diurétiques in utero.

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