FETAL AND MATERNAL DOPPLER MODIFICATIONS DURING THERAPY WITH ANTIHYPERTENSIVE DRUGS

Objective: The purpose of our study was to evaluate the eventual modif ications of flow velocity waveforms in fetal-maternal circulation duri ng therapy with nifedipine and atenolol. Methods: We studied 22 pregna nt women with hypertension-preeclampsia between 20 and 36 weeks' gesta tion. Twelve patients were treated with 50 mg/day of atenolol and 10 r eceived 40-80 mg/day of nifedipine. We evaluated pulsatility and resis tance index in umbilical, aortic, cerebral, and uterine arteries befor e therapy, at 60-120 min, and 2 days after nifedipine intake. In the a tenolol group, the Doppler study was performed before dosing, at 5 and 24 h, and at 7 days after starting therapy. Results: No significant d ifferences were shown in umbilical and uterine circulation at any time in the patients treated with nifedipine; we noted a significant perce ntage increase in pulsatility index (PI) values in the middle cerebral artery at 60 min (P < 0.03). However, at 120 min and 48 h, the values returned to similar basal levels. In the group of patients treated wi th atenolol, no significant percentage changes were noted in the umbil ical district; in the middle cerebral artery we found a slow jet progr essive decrease in PI values with a significant difference at 7 days ( P < 0.01). The aortic PI changes showed an opposite pattern with a sig nificant percentage increase at 7 days (P < 0.03). In the uterine dist rict we also noted a progressive increase in the resistance index (RI) values (at 7 days P < 0.05). Conclusions: In our experience, the use of nifedipine could be safer than atenolol in hypertensive pregnancies , with less harmful effects on fetal-maternal circulation.