Nicardipine for severe Hypertension in Pregnancy : The efficacy and safety of nicardipine in the treatment of severe hypertension in pregnancy: a retrospective study.

Ommeren, A. van (2015) Nicardipine for severe Hypertension in Pregnancy : The efficacy and safety of nicardipine in the treatment of severe hypertension in pregnancy: a retrospective study. thesis, Medicine.

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Abstract

Objective: Hypertensive disorders in pregnancy remain a major cause of maternal and fetal morbidity and mortality. To reduce maternal and fetal consequences blood pressure control is essential. Previous research has no definite answer to the treatment of severe hypertension in pregnancy. Nicardipine is used since a long time to decrease blood pressure, but not much data have been published about the treatment with nicardipine in pregnant women. The aim of this study is to determine the effectiveness and safety of nicardipine in severe hypertension in pregnancy. Methods: Since nine years nicardipine is used in two clinical centers, Erasmus MC in Rotterdam and Isala in Zwolle. This is a retrospective study of all pregnant women with severe hypertension who were treated with nicardipine from January 2006 until October 2014. The primary endpoints were successful treatment and hypotension. Secondary endpoints were minutes until target pressure is reached, maternal and neonatal side effects, as well as a comparison of the groups with different starting dosage of nicardipine, and Rotterdam and Zwolle. Results: In this study 609 women were included. Primary outcome: success rate of nicardipine of 99% and 39% had a diastolic blood pressure below 70 mmHg. Secondary outcome: 12% women had a diastolic blood pressure below 60 mmHg. In 2% occurred clinical relevant hypotension what led to fetal distress and a section cesarean. Blood pressure was already reduced significantly within one hour (p<0.001) and reached target pressure with a median of 89 minutes. Other maternal side effects were headache, tachycardia, phlebitis and nausea. In 3% therapy was discontinued due to these maternal side effects. No severe fetal or neonatal adverse effects occurred. Risk factors for hypotension are no administration of 500 ml colloid fluid before the start with an odds ratio of and gestational age with an odds ratio of 1.1 for each week. There were no differences found between different starting dosages of nicardipine.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervised by and Nij Bijvank, S.W.A. MD and perinatologist Department and of Obstetrics and Gynecology and Isala, Zwolle
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:59
Last Modified:	25 Jun 2020 10:59
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1922

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