What is the primary treatment for pregnancy-induced hypertension in the acute setting?

• A. Nifedipine
• B. Hydralazine
• C. Methyldopa
• D. Labetalol

Answer: (B)

In an acute hypertensive crisis during pregnancy, the goal is a rapid, controlled drop in blood pressure to protect the mother while preserving placental perfusion. Intravenous hydralazine fits this need because it directly dilates arterioles, causing a quick fall in systemic vascular resistance. Its effects are easily titratable and short-acting, so you can adjust the dose to reach a safe target without overshooting. This reliability and controllability make it the preferred option in the urgent setting. Be aware of potential side effects like tachycardia, headaches, and flushing, and monitor both mother and fetus closely. Other agents (like labetalol or calcium-channel blockers) can be used in different scenarios, but hydralazine’s rapid, titratable action makes it the best fit for acute PIH management.