USE OF NIFEDIPINE IN THE HYPERTENSIVE DISEASES OF PREGNANCY

OBJECTIVE: To review the available data about the use of nifedipine to treat hypertension in pregnancy. DATA SOURCES: All English language c ases and studies published after 1984 and indexed in MEDLINE, Excerpta Medica, and BIOSIS PREVIEWS under the headings nifedipine, hypertensi on in pregnancy, uteroplacental blood flow, maternal/fetal hemodynamic s, preeclampsia, and pregnancy outcome. MAIN OUTCOME MEASURES: The pri mary outcome indicators included the safety and antihypertensive effic acy of nifedipine in pregnancy; the effects of nifedipine on maternal/ fetal hemodynamics; and the effect, if any, of nifedipine on perinatal outcome. CONCLUSIONS: Traditional drug therapy choices for hypertensi on in pregnancy continue to be hydralazine for acute reduction of bloo d pressure and methyldopa for the management of chronic hypertension. Current data indicate that nifedipine is an appropriate second-line an tihypertensive medication in pregnancy, but more clinical trials are n eeded before it can be considered an appropriate choice for initial th erapy. As do other antihypertensive agents, nifedipine provides matern al benefit by lowering blood pressure and reducing the risk of cerebra l hemorrhage and end-organ damage. However, perinatal benefit of nifed ipine remains to be established.