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Nifedipine versus expectant management in mild to moderate hypertension in pregnancy
Author(s) -
Gruppo di Studio Ipertensione in Gravidanza
Publication year - 1998
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1998.tb10201.x
Subject(s) - nifedipine , medicine , pregnancy , blood pressure , gestation , caesarean section , randomized controlled trial , obstetrics , hypertension in pregnancy , anesthesia , preeclampsia , calcium , genetics , biology
Objective To compare the effect of routine treatment with the calcium channel blocker nifedipine in mild to moderate hypertension in pregnancy. Design Randomised clinical trial. Setting General and University hospitals. Participants Pregnant women, between 12 and 34 weeks of gestation, with chronic, pregnancy‐induced or unclassifiable hypertension and diastolic pressure between 90 and 110 mmHg. Methods Eligible women were randomly assigned treatment with slow‐release nifedipine, 10 mg twice daily until delivery, or no treatment. In the no treatment group nifedipine was given if the diastolic pressure exceeded 110 mmHg. A total of 145 women were assigned nifedipine and 138 no treatment. Results In the nifedipine group 45.0% of women were delivered before term, compared with 37.0% in the no treatment group; the difference was not significant. In all, 56.3% of women allocated nifedipine and 62.1% allocated no treatment underwent caesarean section; the difference was not statistically different (OR 0.7,95% CI 041.1). There was no significant difference between the two groups in the percentage of babies weighing less than the 10th centile (OR 0.8; 95% CI 0.4–1.4) or in the mean birthweight. The frequency of admission of infants to the neonatal intensive care unit was not affected by treatment. Conclusions This trial found no benefit on pregnancy outcome of routine treatment with nifedipine. In clinical practice, the treatment of hypertension in pregnancy may be delayed until the hypertension becomes severe.