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Maternal and fetal parameters in pregnant woman undergoing tocolysis with nifedipine

Abstract

Objectives:

to evaluate the effects of nifedipine with tocolysis under maternal and fetal parameters.

Methods:

a cohort study with 40 pregnant women admitted at a high-risk pregnancy ward to inhibit premature labor between September/2010 to May/2012. Nifedipine was used as a 20mg sublingual attack dose and maintained 20mg every six and eight hours orally. The variables of the analysis were fetal heart rate (FHR), maternal heart rate (MHR), systolic blood pressure (SBP) and diastolic blood pressure (DBP), and amniotic fluid index (AFI). All the variables were evaluated prior to administrating nifedipine and approximately after 6 hours and every 24 hours, until hospital discharge.

Results:

there were no modification of the FHR (p=0.48) and the SBP (p=0.29). The MHR increased after 24 hours, but with no statistical difference (p=0.08), returning to similar levels as at admission within 48 hours. The DBP decreased at 6 (p=0.04) to 72 hours, being stable afterwards. The AFI decreased significantly at 24, 48 and 72 hours.

Conclusions:

the use of high doses of nifedipine with tocolysis causes a decrease of the maternal’s diastolic blood pressure and consequently decreases the amniotic fluid index, but probably without any clinical repercussions.

Key words:
Tocolysis; Nifedipine; Amniotic fluid index; Premature labor; Prenatal ultrasonography

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