Skip to main content
SMFM 2026 Pregnancy Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Additional registration fee required
Additional registration fee required
Faculty have requested this content not be shared outside of the session
Faculty have requested this content not be shared outside of the session
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
Poster Icons
Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 3

Category: Hypertension

Poster Session 3

(877) Management of Pregnancies with Chronic Hypertension where Calcium Channel Blockers and Beta-adrenergic Blockers are Contraindicated

Thursday, February 12, 2026
10:30 AM - 12:00 PM  

    Submitting Author(s)

  • Daniel J. Martingano, DO, MBA, PhD

    Clerkship Director, IRB Chair, Associate Program Director / Division Chair
    St. John's Episcopal Hospital-South Shore / Lake Erie College of Osteopathic Medicine
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

    • Presenting Author(s)

  • Melody Boafo, MD

    OB/GYN Resident
    St. John's Episcopal Hospital-South Shore
    hackettstown, New Jersey, United States

    • Coauthor(s)

  • AR

    Andrea Rivera, MD

    OB/GYN Resident
    Wyckoff Heights Medical Center
    Wyckoff Heights Medical Center / Brooklyn, New York, United States

  • CA

    Crystal Awad, DO

    OB/GYN Resident
    Jamaica Hospital Medical Center
    Jamaica Hospital Medical Center / Queens, New York, United States

  • Marwah Al-Dulaimi, MD (she/her/hers)

    OB/GYN Resident
    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore, New York, United States

  • SG

    Samantha Giler, MS

    St. John's Episcopal Hospital-South Shore / Lake Erie College of Osteopathic Medicine
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

  • JD

    Jaina Diaz-Kelly, MS

    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

  • KM

    Kelly Mondey, MS

    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

  • KH

    Kristen Henry, MS

    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

  • BR

    Brenna M. Regan, MS

    William Carey University College of Osteopathic Medicine
    William Carey University / Hattiesburg, Mississippi, United States

  • KC

    Kristen Cohen, CNM, DNP

    CNM WHNP-OB
    RWJBarnabas Health Trinitas Regional Medical Center
    RWJBarnabas Trinitas Regional Medical Center / Elizabeth, New Jersey, United States

  • IG

    Iris Gomez-Brito, CNM, DNP

    DNP-CNM
    RWJBarnabas Trinitas Regional Medical Center
    RWJBarnabas Trinitas Regional Medical Center / Elizabeth, New Jersey, United States

  • GO

    Gloria Otoo, MSN, PhD

    RNC-OB
    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

  • ES

    Eddie Santana, DO

    MFM Fellow
    Good Samaritan University Hospital / NYIT
    Good Samaritan University Hospital / West Islip, New York, United States

  • JM

    Jacqueline Marecheau, MD

    Chairperson, Department of OB/GYN
    St. John's Episcopal Hospital-South Shore
    St. John's Episcopal Hospital-South Shore / Far Rockaway, New York, United States

Objective:

Calcium channel blockers (CCB) and Beta-adrenergic blockers (BB) remain essential for pregnancies complicated by chronic hypertension (CHTN), yet optimal alternatives where both CCB and BB are contraindicated remains undefined. This study sought to evaluate the efficacy of alternative antihypertensives for CHTN where both CBB and BB are contraindicated.

Study Design:

We conducted a multi-center, prospective observational study from 7/2022 to 7/2025 and included all pregnant women diagnosed with CHTN from 28 0/7 to 41 0/7 weeks-gestation.

Monotherapy medications included oral hydralazine 50mg thrice-daily (HZ), clonidine 0.1mg/24-hours weekly patch (CLD), prazosin 5mg twice-daily (PRZ), and methyldopa 500mg thrice-daily (MDA). Medication choice was based on physician preference. Each regimen was compared to the total patients receiving a different regimen. All patients received aspirin 81mg daily. Primary outcomes included events of blood pressure >160/110 mm Hg (HE), superimposed preeclampsia (PEC), patient-reported missed doses (MD), and patient-reported symptomatic improvement (SI), as discrete events. Patients with cardiac or psychiatric disorders, or multi-fetal gestations were excluded.

Results:

The study included 707 patients, with 141 receiving HZ, 133 receiving CLD, 113 receiving PRZ, and 187 receiving MDA. Baseline demographic factors were not significantly different. Patients receiving CLD had lower rates of MD (3.0% v. 29.9% p< 0.001) and HE (19.5% v. 28.7%, p=0.003), with a 91% (RR=0.09, 95% CI 0.01-0.22, p< 0.001) and 42% (RR=0.58 95% CI 0.42-0.71, p=0.040) decreased risk in confounder-adjusted models, respectively. Patients receiving PRZ had greater rates of SI (69.9% v. 50.7% p=0.002), with a 71% (RR=1.71, 95% CI 1.63-1.84, p=0.001) increased likelihood in adjusted models. Patients receiving HZ had lower rates of PEC (14.8% v. 20.0%, p=0.040), with a 22% (RR=0.79, 95% CI 0.46-0.89, p=0.050) decreased risk in adjusted models.

Conclusion:

PRZ, HZ, and CLD are safe and effective alternatives for pregnancies complicated by CHTN where CCB and BB are contraindicated.