title: Calcium channel blockers in the management of preterm labor and hypertension in pregnancy.
abstract: Calcium channel blockers (CCBs) have the ability to inhibit contractility in smooth muscle cells. CCBs have an already established role in the treatment of non-pregnant hypertension and angina pectoris. Some epidemiological studies found an association between the use of CCBs and an increase in cardiovascular mortality, malignancy, and gastrointestinal bleeding. More recent studies with many more patients and a longer follow-up did not find these associations. In obstetrics CCBs have become increasingly popular for the management of preterm labor and pregnancy-induced hypertensive disorders. Meta-analysis shows that use of nifedipine in comparison with betamimetics is associated with a more frequent successful prolongation of pregnancy in case of preterm labor, resulting in significantly fewer admissions of newborns to the neonatal intensive care unit (NICU), and is associated with a lower incidence of respiratory distress syndrome. No adverse fetal side effects in humans have been reported with the use of nifedipine for obstetric indications. Nifedipine is an effective and safe drug to use when tocolytic therapy is indicated for preterm labor. In preeclampsia nifedipine effectively lowers blood pressure and can be a good alternative for (di) hydralazine.
authors.affiliation: Departments of Obstetrics and Gynecology, Free University Hospital Amsterdam, Amsterdam, The Netherlands. hoog.pap@wxs.nl
authors.forename: D N
authors.initials: DN
authors.lastname: Papatsonis
authors.forename: C A
authors.initials: CA
authors.lastname: Lok
authors.forename: J M
authors.initials: JM
authors.lastname: Bos
authors.forename: H P
authors.initials: HP
authors.lastname: Geijn
authors.forename: G A
authors.initials: GA
authors.lastname: Dekker
mesh_terms: D001942:Breast Feeding; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008431:Maternal-Fetal Exchange; D009543:Nifedipine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000188:drug therapy*; D015149:Tocolytic Agents / Q000627:therapeutic use
chemical_list: D002121:Calcium Channel Blockers; D015149:Tocolytic Agents; D009543:Nifedipine