Effect of nifedipine on fetal and maternal hemodynamics and blood gases in the pregnant ewe

Blea, Clarence W.; Barnard, Jerald M.; Magness, Ronald R.; Phernetton, Terrance M.; Hendricks, Susan K.

doi:10.1016/s0002-9378(97)70622-7

Cited by 46 publications

(25 citation statements)

References 18 publications

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“…They suggested that fetal acidosis after CCB infusion is primarily due to a decrease in uterine blood flow rather than a direct fetal effect of the drug. Blea and colleagues infused instrumented sheep with low dose nifedipine corresponding with human concentrations 37. They found hypoxia and acidosis in the sheep fetus without persistent decreases in uteroplacental or fetoplacental blood flows or blood pressures.…”

Section: Fetal Effectsmentioning

confidence: 99%

Management of preterm labor: atosiban or nifedipine?

Heus

Mulder²,

Visser³

2010

IJWH

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Preterm birth is strongly associated with neonatal death and long-term neurological morbidity. The purpose of tocolytic drug administration is to postpone threatening preterm delivery for 48 hours to allow maximal effect of antenatal corticosteroids and maternal transportation to a center with specialized neonatal care facilities. There is uncertainty about the value of atosiban (oxytocin receptor antagonist) and nifedipine (calcium channel blocker) as first-line tocolytic drugs in the management of preterm labor. For nifedipine, concerns have been raised about unproven safety, lack of placebo-controlled trials, and its off-label use. The tocolytic efficacy of atosiban has also been questioned because of a lack of reduction in neonatal morbidity. This review discusses the available evidence, the pros and cons of either drug and aims to provide information to support a balanced choice of first-line tocolytic drug: atosiban or nifedipine?

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Section: Fetal Effectsmentioning

confidence: 99%

Management of preterm labor: atosiban or nifedipine?

Heus

Mulder²,

Visser³

2010

IJWH

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“…IV atosiban (300 μg/min) used in women scheduled for elective cesarean section demonstrated no significant effect on the umbilical cord blood gases, and maternal hematocrit 93. In contrast Blea et al found that in pregnant ewes, IV nifedipine was associated with fetal hypoxia and acidosis 94. There are also concerns with respect to the number of published reports of adverse feto–maternal events after the use of CCBs, compared to the use of atosiban.…”

Section: Adverse Effects Of Tocolyticsmentioning

confidence: 98%

Critical appraisal and clinical utility of atosiban in the management of preterm labor

Sanu

Lamont

2010

TCRM

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Preterm birth is the major cause of perinatal morbidity and mortality in the developed world, and spontaneous preterm labor is the commonest cause of preterm birth. Interventions to treat women in spontaneous preterm labor have not reduced the incidence of preterm births but this may be due to increased risk factors, inclusion of births at the limits of viability, and an increase in the use of elective preterm birth. The role of antibiotics remains unproven. In the largest of the randomized controlled trials, evaluating the use of antibiotics for the prevention of preterm births in women in spontaneous preterm labor, antibiotics against anaerobes and bacterial vaginosis-related organisms were not included, and no objective evidence of abnormal genital tract flora was obtained. Atosiban and nifedipine are the main tocolytic agents used to treat women in spontaneous preterm labor, but atosiban is the tocolytic agent with the fewest maternal – fetal side effects. A well conducted randomized controlled trial comparing atosiban with nifedipine for their effectiveness and safety is needed.

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“…Blea et al [12] se sont intéressés à l'effet de la nifé-dipine sur l'hémodynamique foetale et maternelle et les éventuelles modifications des gaz du sang chez des brebis gestantes. Dix brebis gestantes ont reçu de la nifédipine par voie intra-veineuse à des doses correspondantes à celles utilisées chez l'humain en tocolyse d'attaque.…”

Section: Données De L'expérimentation Animaleunclassified