Hypertensive disorders in pregnancy remain a leading cause of maternal and neonatal morbidity and mortality worldwide, including in Indonesia. Preeclampsia contributes significantly to maternal deaths due to uncontrolled blood pressure and inappropriate drug use. This study aims to evaluate the prescribing behavior, therapeutic outcomes, and safety of antihypertensive drugs used in preeclampsia management in secondary hospitals. A retrospective cohort study was conducted among 832 hospitalized patients with preeclampsia in Yogyakarta, Indonesia, from 2018 to 2024. Analytical and descriptive methods were employed to examine both patient characteristics and treatment variables. This study found that complete recommended therapy was predominantly administered among patients in the third trimester (100%) and those with gravida <3 (72.9%). Nifedipine was the most frequently prescribed drug (63.2%). In terms of effectiveness, nifedipine monotherapy achieved target blood pressure in 48.4% of patients, compared to 15.6% in methyldopa monotherapy, while combination therapy (nifedipine–methyldopa) achieved 6.1%. These findings are consistent with current clinical guidelines, where methyldopa is considered a safe first-line antihypertensive, while nifedipine serves as an effective alternative to achieve optimal maternal and fetal outcomes.
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