Changes in blood velocities of fetal circulation in association with fetal heart rate abnormalities: effect of sublingual administration of nifedipine.
Nifedipine has been used to treat hypertension in pregnancy, and does not influence fetal or uteroplacental circulations in patients with preeclampsia. A 29-year-old multi-gravid woman presented at 32 weeks' gestation with significant elevation of her blood pressure. After sublingual administration of nifedipine, the blood pressure decreased from 208/122 to 136/96 mm Hg at 30 minutes. In her growth-retarded fetus with abnormal flow velocity waveforms, pulsatility index values for middle cerebral artery and umbilical artery did not change; however, peak systolic velocities, end-diastolic velocities, and time-averaged mean peak velocities for these arteries became significantly elevated. Simultaneously, severe variable decelerations and late decelerations occurred. The adverse effect of nifedipine on fetal circulation might occur in a growth-retarded fetus with abnormal flow velocity waveforms.
Hata
T
T
Department of Obstetrics and Gynecology, Shimane Medical University, Izumo, Japan.
Manabe
A
A
Hata
K
K
Kitao
M
M
D000286:Administration, Sublingual; D000328:Adult; D001783:Blood Flow Velocity / Q000187:drug effects*; D005260:Female; D005317:Fetal Growth Retardation / Q000150:complications / Q000503:physiopathology; D006340:Heart Rate, Fetal / Q000187:drug effects*; D006801:Humans; D009543:Nifedipine / Q000008:administration & dosage / Q000009:adverse effects*; D011225:Pre-Eclampsia / Q000150:complications / Q000188:drug therapy*; D011247:Pregnancy
D009543:Nifedipine