Effect of Nifedipine on Uterine and Middle Cerebral Artery Doppler in Pre-Eclampsia Patients

Abstract

Background: Preeclampsia AKA PE was defined based on NICE guidelines as new hypertension presenting after 20 weeks with significant proteinuria. Severe pre-eclampsia is pre-eclampsia with severe hypertension and/or with symptoms, and/or biochemical and/or hematological impairment. Nifedipine is used for control of blood pressure in cases with preeclampsia aiming to prevent rise of blood pressure during expectant management of these cases. Objective: To evaluate changes in uterine artery and middle cerebral artery Doppler indices before and a week after Nifedipine administration for control of blood pressure in PE patients. Design: Prospective observational study over six months that started to recruit patients from Mansoura university hospitals antenatal care clinics from May, 2019 to December, 2019. Methods: Doppler on uterine and middle cerebral artery was done before and a week after administration of Nifedipine. Dose of nifedipine: starting dose 10 mg orally twice daily increased after 48hs according to response. Maximum safe dose is 60 mg per day in dividing doses 8 hours apart. Drug stopped immediately if severe side effects like sudden hypotension where IV fluids and corticosteroid to support blood pressure will be commenced immediately. If no respons after maximum dose of medication conservative management was abandoned and delivery took place. Main Outcome Measure: Changes in uterine and middle cerebral artery Doppler indices before and after Nifedipine administration. Use of these changes to evaluate decisions for conservative management in preeclampsia patients. Conclusion: Nifedipine is a valid option to treat hypertensive patients, however more extended studies on fetal effects are required.