The effect of acute and chronic antihypertensive therapy on maternal and fetoplacental Doppler velocimetry.
Maternal and feto-placental Doppler flow velocity waveforms were studied during acute and chronic antihypertensive therapy in patients with pregnancy-induced hypertension. Eight primigravidae were acutely treated with oral nicardipine. Diastolic blood pressure fell at 30, 45 and 60 min after nicardipine. The uteroplacental systolic/diastolic ratio rose significantly at 30 min, but this change was no longer apparent at 60 min. Umbilical artery and maternal brachial artery systolic/diastolic ratios were unchanged. Fifteen patients with mild pre-eclampsia were chronically treated with oral pindolol. Diastolic blood pressure fell significantly within 24 h. The uteroplacental systolic/diastolic ratio rose 3 days after pindolol. Brachial artery or umbilical artery systolic/diastolic ratios were unchanged. A control group of 15 patients with untreated mild pre-eclampsia showed a significant rise in uteroplacental and umbilical artery systolic/diastolic ratios within 7 days of starting recordings. In patients with pregnancy-induced hypertension, acute and chronic blood pressure reduction was associated with no change in umbilical artery or maternal brachial artery Doppler systolic/diastolic ratios and a transient rise in the uteroplacental systolic/diastolic ratio.
Walker
J J
JJ
University Department of Obstetrics and Gynaecology, Glasgow Royal Maternity Hospital, Rottenrow, U.K.
Mathers
A
A
Bjornsson
S
S
Cameron
A D
AD
Fairlie
F M
FM
D001794:Blood Pressure; D001916:Brachial Artery / Q000503:physiopathology; D005260:Female; D005333:Fetus / Q000098:blood supply*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D007231:Infant, Newborn; D009529:Nicardipine / Q000627:therapeutic use*; D010869:Pindolol / Q000627:therapeutic use; D010920:Placenta / Q000098:blood supply*; D011225:Pre-Eclampsia / Q000188:drug therapy / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000503:physiopathology; D014463:Ultrasonography; D014469:Umbilical Arteries / Q000503:physiopathology
D010869:Pindolol; D009529:Nicardipine