Borghi C, Immordino V, Cassani A, Bacchelli S, Degli Esposti
D, Bencivenga C, Bovicelli L, Ambrosion
Safety aspects of calcium channel blockers in patients with
hypertension associated with pregnancy: A retrospective study
12th Annual ASH Meeting
Am J Hypertens
(Apr) 10:134A 1997
Research into the treatment of hypertensive pregnant women has been
slow. Ethical issues have limited studies leaving clinicians with
case studies and older studies primarily looking at safety of
methyldopa in pregnancy. The safety of calcium channel blockers has
not previously been evaluated in a systematic way.
This study was a retrospective study looking at safety of calcium
channel blockers in pregnancy. 1640 pregnant women were evaluated to
assess the post-partum maternal and fetal outcome. 44 women with
hypertension in pregnancy were compared to the remaining patients.
91% were treated with nifedipine and 9 % with verapamil. Blood
pressure was increased in the patients with hypertension and was
normalized with the calcium channel blocker therapy. There were no
difference in maternal age or gestational age between the two groups.
Proteinuria, peripheral edema, elevated serum uric acid, ALT and AST
were higher in the patients with hypertension. No differences were
seen in maternal outcome although there was an increase in the
incidence of c-section (50% vs 17%). Fetal outcome was comparable
between the two groups in relation to fetal age, % abortion, Apgar 1
minute, and Apgar 5 minutes.
Comment: These authors concluded that these preliminary data in
a large survey seem to suggest that calcium channel blockers
particularly nifedipine, can be safely used in pregnancy. This is
important data looking at the safety of calcium channel blockers,
Information on the duration of treatment, dosage ranges and
distinction between patients with chronic hypertension, pregnancy
induced hypertension and eclampsia need to be evaluated. (Betsy
Ripley, M.D., Medical College of Virginia)
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12th Annual ASH Meeting
H: Special problems :
Women
H: Drug therapy :
Calcium channel blockers