An effect of maternal nifedipine therapy on fetoplacental blood flow: a prospective study

Namazov, Ahmet; Grin, Leonti; Karakuş, Resul; Uludoǧan, Mehmet; Ayvaci, Habibe

doi:10.1007/s00404-018-4839-9

Cited by 8 publications

(4 citation statements)

References 20 publications

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“…There are a limited number of studies that evaluate the effects of maternal nifedipine treatment on fetoplacental blood flow in maternal uterine arteries and fetal umbilical arteries. Some studies demonstrate that the maternal uterine artery and fetal umbilical artery RI values did not change significantly 48 hours after nifedipine treatment, but some studies indicate that the uterine artery RI values did change significantly 11 19 20 . Such a difference may be due to the use of different doses of nifedipine in the studies.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Nifedipine Used in the Treatment of the Threat of Preterm Labor on Total Uterine Artery Blood Volume Flow Rate

Eroğlu¹,

Turğal²,

Altınboğa³

et al. 2023

Z Geburtshilfe Neonatol

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Purpose Evaluation of the effect of maternal nifedipine treatment on total uterine artery blood volume flow rate (TVFR). Methods In this prospective study, 43 women who were admitted to the Perinatology Department of the University of Health Sciences Etlik Zübeyde Hanım Gynecology Training and Research Hospital, with the diagnosis of the threat of preterm labor, and 40 healthy pregnant women, who were randomly selected as the control group, were evaluated between July 1, 2018, and September 1, 2018. A transabdominal ultrasound examination of uterine arteries was performed both before and 48 hours after administration of oral nifedipine for TVFR measurement. For the final analysis, the TVFR levels of the group diagnosed with the threat of preterm labor and the control group were compared. Results There was no significant difference in either uterine artery pulsatility index or resistance index values as well as the diameters of the uterine arteries after nifedipine treatment (p>0.05 for all). Total uterine artery blood volume flow rate (TVFR) was 424.66±236.74 mL/min before and 543.39±309.68 mL/min after treatment with nifedipine and was statistically significantly higher (p < 0.05). ConclusionsOur study showed a statistically significant increase in total uterine artery blood volume flow rate 48 hours after oral nifedipine treatment.

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Section: Discussionmentioning

confidence: 99%

“…Pulsatility index (PI) and resistance index (RI) values, which show vascular resistance parameters, were examined after nifedipine treatment, and an increase in uterine blood flow was detected [11]. Some authors, by contrast, have reported that nifedipine loading treatment does not affect fetal blood flow [12].…”

Section: Original Articlementioning

confidence: 99%

Effect of Nifedipine Used in the Treatment of the Threat of Preterm Labor on Total Uterine Artery Blood Volume Flow Rate

Eroğlu¹,

Turğal²,

Altınboğa³

et al. 2023

Z Geburtshilfe Neonatol

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“…The studies that are available in literature to evaluate the doppler effect of Nifedipine in PE patients are scarce. However, a thorough review of databases MEDLINE/ PUBMED and Cochrane registry was done to find only three studies [11,12,13] .…”

Section: Discussionmentioning

confidence: 99%

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

Mohamed

Shalaby²,

Eid³

2022

Evidence Based Women's Health Journal

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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.

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“…In addition, differential changes in the placental and cerebral blood flow resistances may affect the cerebroplacental Doppler ratio, and the overall distribution of cardiac output. In addition, cardiac effects of nifedipine may affect the contractility and diastolic cardiac function (Namazov et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

The Short-Term Effect of Nifedipinetocolysis on Placental, Fetal Cerebral and Atrioventricular Doppler Waveforms

2022

Al-Azhar Medical Journal

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Background: Preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. Nifedipine is characterized by lack of tachyphylaxis and by a reversible effect after discontinuation of the treatment. The vascular relaxation obtained with nifedipine in hypertensive women does not occur significantly in normotensive patients. This explains the absence of severe hypotension induced by high doses of calcium antagonists for tocolysis in normotensive patients.Objective: To assess the acute effects of maternal nifedipine administration on placental and fetal cerebral blood flow resistance as well as on diastolic fetal cardiac function. Patients and methods:This study was an observational prospective study, on 30 healthy pregnant women with singleton fetuses who admitted to labor ward with the diagnosis of preterm labor, gestational ages of 28-34 weeks, intact membranes and received nifedipine maintenance tocolysis for persistent uterine contractions under surveillance of maternal vital signs and Doppler examinations performed prior to nifedipine administration, 3 hours after the first dose and after 48 hours on umbilical artery, middle cerebral artery, mitral valve and tricuspid valve. The study was done at Bab El-Shaaria University Hospital during the time of the study between August 2019 and September 2020. Results:In this study we found that, the P value for both systolic and diastolic blood pressure after 3 hours and after 48 hours was <0.001 which is statistically significant. Also the study found that, as regards the maternal heart rate, the P value was 0.065 which is statistically insignificant. As regards the fetal heart rate, P-value was 0.062 which is statistically insignificant. As regards Umbilical artery PI, P-value was 0.149 which is statistically insignificant. Regarding umbilical artery S/D, P-value was 0.284 which is statistically insignificant. As regards MCA PI, P-value was <0.001 which is statistically significant. Regarding MCA S/D, P-value was 0.562 which is statistically insignificant. Also results found that, the P-value for cerebroplacental ratio was <0.001 which is statistically significant. The mean E/A values, TVIs and TVI x FHR values after 3 hrs and after 48 hrs were unchanged from the baseline values. Conclusion:Nifedipine maintenance tocolysis is associated with significant changes in maternal vital parameters, utero-placental blood-flow resistance and results in fetal redistribution. Fetal cardiac diastolic function is unaffected and the significant redistribution is likely to be attributable to altered cerebral blood flow.

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An effect of maternal nifedipine therapy on fetoplacental blood flow: a prospective study

Abstract: Our study showed that 24 and 48 h after oral nifedipine therapy, there is a significant increase in fetal MCA and maternal uterine artery blood flow, while fetal umbilical artery and ductus venosus Doppler values do not change.

Cited by 8 publications

References 20 publications

Effect of Nifedipine Used in the Treatment of the Threat of Preterm Labor on Total Uterine Artery Blood Volume Flow Rate

Effect of Nifedipine Used in the Treatment of the Threat of Preterm Labor on Total Uterine Artery Blood Volume Flow Rate

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

The Short-Term Effect of Nifedipinetocolysis on Placental, Fetal Cerebral and Atrioventricular Doppler Waveforms

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