Anesthesia Knowledge Test-6 (AKT-6) Practice

The preferred agent to treat hypotension in a pregnant patient is phenylephrine. This is primarily because phenylephrine, an alpha-1 adrenergic agonist, effectively increases systemic vascular resistance and arterial blood pressure without significantly increasing heart rate or causing potential fetal compromise, which is a critical consideration in obstetric patients. In contrast, while ephedrine is sometimes used for hypotension, particularly due to its beta-adrenergic activity that can increase heart rate and cardiac output, it tends to cause greater variability in blood pressure responses and may lead to fetal tachycardia, which can be concerning in prenatal care. Norepinephrine, while effective as a vasopressor, is typically reserved for critical care settings or severe hypotension scenarios and may not be the best first line for the more stable hypotensive pregnant patient. Dopamine can also increase blood pressure but, similar to ephedrine, is less predictable and carries risks of various side effects that are better avoided in a pregnant patient. Overall, phenylephrine’s targeted action with a straightforward mechanism makes it the preferred choice for managing hypotension in pregnant patients, ensuring both maternal and fetal safety.