Calcium channel blockers in the management of preterm labor and hypertension in pregnancy

Calcium channel blockers (CCBs) have the ability to inhibit contractility i n smooth muscle cells. CCBs have an already established role in the treatme nt of non-pregnant hypertension and angina pectoris. Some epidemiological s tudies found an association between the use of CCBs and an increase in card iovascular mortality, malignancy, and gastrointestinal bleeding. More recen t studies with many more patients and a longer follow-up did not find these associations: In obstetrics CCBs have become increasingly popular for the management of preterm labor and pregnancy-induced hypertensive disorders. M eta-analysis shows that use of nifedipine in comparison with betamimetics i s associated with a more frequent successful prolongation of pregnancy in c ase of preterm labor, resulting in significantly fewer admissions of newbor ns to the neonatal intensive care unit (NICU), and is associated with a low er incidence of respiratory distress syndrome. No adverse fetal side effect s in humans have been reported with the use of nifedipine for obstetric ind ications. Nifedipine is an effective and safe drug to use when tocolytic th erapy is indicated for preterm labor. In preeclampsia nifedipine effectivel y lowers blood pressure and can be a good alternative for (di) hydralazine. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.