Patricia Smith, J. Anthony, R. Johanson
Mar 1, 2000
Citations
0
Influential Citations
72
Citations
Quality indicators
Journal
BJOG: An International Journal of Obstetrics & Gynaecology
Abstract
Nifedipine is a dihydropyridine calcium channel blocker that is widely used for the treatment of cardiovascular disorders in nonpregnant individuals. Over the last 15 years its favourable pharmacologic characteristics have resulted in its efficacy and safety being assessed in pregnancy. Its application both as a treatment for acute severe hypertension, as well as for long term use for hypertension in pregnancy, have been explored. The drug has been shown to have a tocolytic effect on uterine smooth muscle and hence its use in the prevention of preterm delivery has been investigated. In this article, the mechanism of action of the drug, as well as the current understanding of its metabolism and pharmacokinetics in pregnancy, is reviewed, including assessment of the literature on the use of nifedipine in the management of hypertension in pregnancy and its use in suppressing preterm labour. A literature search of MEDLINE and the Cochrane Library was conducted for the years 1975 to September 1997 concerning the use of nifedipine in pregnancy, both for the treatment of hypertension and for tocolysis. The keywords used were: nifedipine, calcium channel blockers, pregnancy, hypertension, pre-eclampsia, umbilical artery blood flow, uteroplacental blood flow, teratogenicity, tocolysis, preterm labour; preterm delivery. The reference lists of all identified articles were examined to find additional relevant studies.