A randomized prospective comparison of nifedipine and bed rest versus bed rest alone in the management of preeclampsia remote from term

Sibai, BM; Barton, JR; Akl, Sherif; Sarinoglu, Cem; Mercer, B

doi:10.1016/0020-7292(93)90580-p

Cited by 32 publications

(39 citation statements)

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“…Prospective controlled studies of metoprololhydralazine, nifedipine and labetalol-methyldopa treatment administered to pregnant women with mild PIH, unclassifiable hypertension or mild PE showed no significant improvement of pregnancy outcome as compared to the non-treated group. [95][96][97][98] Labetalol had no effect on development of proteinuria in a trial of 114 women with PIH and nifedipine had no effect on PE-related hypocalciuria as compared to the control than those of the non-treated/placebo group. Decrease in mean arterial pressure of 10 mmHg was associated with a 145 g decrease in mean birth weight, as found in a post-hoc analysis.…”

Section: Mild To Moderate Hypertensionmentioning

confidence: 99%

Pregnancy-Induced hypertension

et al. 2015

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pregnancy-induced hypertension (pIh) complicates 6-10% of pregnancies. It is defined as systolic blood pressure (sbp) >140 mmhg and diastolic blood pressure (dbp) >90 mmhg. It is classified as mild (sbp 140-149 and dbp 90-99 mmhg), moderate (sbp 150-159 and dbp 100-109 mmHg) and severe (SBP ≥160 and DBP ≥110 mmHg). PIH refers to one of four conditions: a) pre-existing hypertension, b) gestational hypertension and preeclampsia (pe), c) pre-existing hypertension plus superimposed gestational hypertension with proteinuria and d) unclassifiable hypertension. pIh is a major cause of maternal, fetal and newborn morbidity and mortality. women with pIh are at a greater risk of abruptio placentae, cerebrovascular events, organ failure and disseminated intravascular coagulation. fetuses of these mothers are at greater risk of intrauterine growth retardation, prematurity and intrauterine death. ambulatory blood pressure monitoring over a period of 24 h seems to have a role in predicting deterioration from gestational hypertension to pe. antiplatelet drugs have moderate benefits when used for prevention of pe. treatment of pIh depends on blood pressure levels, gestational age, presence of symptoms and associated risk factors. non-drug management is recommended when sbp ranges between 140-149 mmhg or dbp between 90-99 mmhg. blood pressure thresholds for drug management in pregnancy vary between different health organizations. according to 2013 esh/esc guidelines, antihypertensive treatment is recommended in pregnancy when blood pressure levels are ≥150/95 mmHg. Initiation of antihypertensive treatment at values ≥140/90 mmHg is recommended in women with a) gestational hypertension, with or without proteinuria, b) pre-existing hypertension with the superimposition of gestational hypertension or c) hypertension with asymptomatic organ damage or symptoms at any time during pregnancy. methyldopa is the drug of choice in pregnancy. atenolol and metoprolol appear to be safe and effective in late pregnancy, while labetalol has an efficacy comparable to methyldopa. angiotensin-converting enzyme (ace) inhibitors and angiotensin II antagonists are contraindicated in pregnancy due to their association with increased risk of fetopathy.

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Section: Mild To Moderate Hypertensionmentioning

confidence: 99%

Pregnancy-Induced hypertension

et al. 2015

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“…Sibai et al showed significant reduction in the systolic (p <0.0001) and diastolic blood pressure (p <0.0001) with oral nifedipine in 200 women with pre-eclampsia between 26 and 36 weeks of gestation. 12 Another study by Bharathi KN et al stated both methyldopa and nifedipine showed equal effect on reducing the blood pressure. 13 Jayasudha et al, reported a significant reduction in systolic and diastolic BP after the use of methyl dopa with nifedipine.…”

Section: Figure 1: Distribution Of Cases According To Gestational Agementioning

confidence: 98%

Efficacy of methyldopa versus nifedipine in mild and severe pregnancy induced hypertension

Togarikar¹

2017

Int J Reprod Contracept Obstet Gynecol

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Background: Hypertension and its associated disorders are major health concerns during pregnancy. Antihypertensive therapy prescribes, when blood pressure is >140/90 mm of Hg, to minimize elevated blood pressure. The present study aimed to assess the efficacy of nifedipine and methyldopa in the antihypertensive treatment of mild and severe pregnancy induced hypertension (PIH).Methods: A total one hundred Patients attending antenatal clinic of the department between 26-37 weeks of gestation suffering from PIH were recruited. Participants were divided in to two groups i.e. group-I consists of 50 patients medicated with oral methyldopa and group-II consists of 50 patients treated with Nifedipine 10mg.Results: Methyldopa reduced systolic blood pressure (SBP) from 162±19.6 to 140.3±10.01 and diastolic blood pressure (DBP) from 99.6±8.8 to 96.17±6.4. Nifedipine reduced SBP from 99.6±8.8 to 96.17±6.4 and DBP from 99.2± 7.4 to 93.45±12.3. Response to methyldopa and nifedipine was almost similar in mild PIH but in severe PIH, 65.5% of patients required additional drug atenolol for adequate control of PIH.Conclusions: Methyldopa and nifedipine are effective drugs for lowering blood pressure when given orally, Methyldopa was found to have a higher incidence of Intra uterine growth restriction while nifedipine was found to have an increased incidence of perinatal mortality.

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“…They showed a significant reduction in the systolic and diastolic blood pressures with nifedipine, as well as reduction in the number of deliveries for severe hypertension. 21 Study conducted by Bharathi K N et al showed rapid fall in systolic blood pressure at 6 hours in both methyl dopa and nifedipine groups and continued to be in normal range till 72 hours but was significant with only in nifedipine group (p<0.01). 22 A prospective clinical trial conducted by Jayawardana J, Lekamge N. et al Srilanka in 126 preganant hypertensive patients showed that nifedipine 30 to 90 mg/day and methyldopa 750 to 2000 mg/day had average systolic blood pressure of 148 and 152 mmHg respectively during pregnancy, average diastolic blood pressure 102 and 104 mmHg respectively.…”

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confidence: 89%