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Mid-trimester fetal-placental velocimetry response to nifedipine may predict early the onset of pre-eclampsia.

Abstract
The effect of nifedipine on fetal-placental blood flow at 22-24 weeks in patients with pregnancy-induced hypertension (PIH) was evaluated. Twenty patients with PIH were submitted to the Doppler evaluation of fetal-placental perfusion at 22-24 weeks. The systo-diastolic (SID) ratio and the pulsatility index (PI) of uterine, umbilical and middle cerebral arteries and systemic blood pressure were recorded before and 7 days after nifedipine administration (10 mg/ per os 3 times/day until delivery). Statistical analysis was performed with paired and unpaired t-test and the two-tailed Fisher exact test. Nifedipine significantly (p < 0.05) decreased the mean systolic pressure in all patients (from 146 to 135 mmHg): 8 patients developed pre-eclampsia (PE) complicated by fetal growth restriction (FGR) (PE group), whilst the remaining were only affected by PIH (PIH group). The gestational age at delivery, neonatal birthweight and 1- and 5-min Apgar scores were significantly (p < 0.001) lower in PE than in PIH women. Nifedipine treatment significantly changed the PI and S/D ratio (mean +/- SEM) of the uterine (PI from 0.66 +/- 0.01 to 0.51 + 0.01; SID ratio: from 2.00 +/- 0.09 to 1.79 + 0.05) and umbilical (PI: from 1.55 +/- 0.04 to 1.40 +/- 0.02; S/D ratio: from 2.45 +/- 0.09 to 2.31+/- 0.09) arteries and the middle cerebral PI (from 1.45 +/- 0.03 to 1.61 +/- 0.01) artery only in PIH, but not in PE patients. Fetal-placental blood flow changes after nifedipine may early identify patients at risk of PE.
AuthorsLuigi Cobellis, Antonio De Luca, Emilia Pecori, Annunziata Mastrogiacomo, Laura Di Pietto, Iolanda Iannella, Felice Fornaro, Cono Scaffa, Giovanni Cobellis, Nicola Colacurci
JournalIn vivo (Athens, Greece) (In Vivo) 2006 Jan-Feb Vol. 20 Issue 1 Pg. 183-6 ISSN: 0258-851X [Print] Greece
PMID16433050 (Publication Type: Journal Article)
Chemical References
  • Nifedipine
Topics
  • Female
  • Fetus (blood supply, drug effects)
  • Humans
  • Nifedipine (administration & dosage)
  • Placenta (blood supply, drug effects)
  • Pre-Eclampsia (diagnosis)
  • Pregnancy
  • Pregnancy Trimester, Second

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