Nicardipine treatment of hypertension during pregnancy.
OBJECTIVE
To assess the effects of nicardipine, a dihydropyridine calcium channel blocker, on the fetus and mother in hypertensive pregnant women.


METHODS
Forty pregnant patients with mild or moderate hypertension received oral nicardipine 20 mg three times a day (mean duration of treatment 9 +/- 2.1 weeks). Twenty patients with severe preeclampsia (diastolic blood pressure greater than 110 mmHg and 24-hour proteinuria greater than 500 mg) received intravenous (IV) nicardipine at 2, 4, or 6 mg/hour according to body weight (mean duration of treatment 5.3 +/- 3.6 days).


RESULTS
Oral nicardipine induced a significant decrease in both systolic and diastolic blood pressures compared with pre-treatment values (P < .001). Intravenous nicardipine decreased diastolic blood pressure below 90 mmHg, at least temporarily, in all 20 patients. Nine patients taking IV nicardipine complained of headaches. Doppler velocimetry remained stable with both oral and IV nicardipine. Neonatal outcome showed no deleterious effect of the treatment.


CONCLUSIONS
Oral or IV nicardipine seems to be safe in hypertensive pregnant patients with the doses used in our study. Assessment of its efficacy will necessitate further clinical randomized trials.
Department of Obstetrics and Gynecology, Hôpital Intercommunal, Creteil, France.
B
B
Carbonne
D
D
Jannet
C
C
Touboul
Y
Y
Khelifati
J
J
Milliez
D000284:Administration, Oral; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D005333:Fetus / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007262:Infusions, Intravenous; D009529:Nicardipine / Q000008:administration & dosage / Q000627:therapeutic use*; D011225:Pre-Eclampsia / Q000188:drug therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D011256:Pregnancy Outcome / Q000453:epidemiology
D009529:Nicardipine