Effects of nifedipine on doppler indices of fetal middle cerebral artery
and umbilical artery in managing hypertensive disorders of pregnancy.
Abstract
Background: Hypertensive disorders of pregnancy affects uteroplacental
and fetoplacental perfusion and may result into poor fetal conditions
and increase perinatal morbidity and mortality. Aim: To study how
effective CCBs are in improving uteroplacental perfusion. Material and
methodology: 120 pregnant women with the gestation ages ranging from
32-40 weeks. Among them sixty were having hypertensive disorders of
pregnancy and sixty were normal pregnant women. In case groups blood
pressure before and after at least one of medication were recorded, and
Doppler ultrasound indices for fetal MCA and UA S/D after at least one
week of medication was also recorded. Results: MCA Peak systolic speed,
UA S/D ratio, MCA Pulsatile index and MCA resistance index mean values
differences between the two groups were not statistically significant
i.e. p-value >0.05 . In correlation with
p-value<0.05,and measured : PS was affected by gestation age
(1.63) , S/D ratio was affected by gestation age(-0.1), systolic blood
pressure (0.013) and age of women (0.007), PI on the other hand was
impacted by gravidity(0.07) and preeclampsia(0.20). RI showed
correlation with chronic hypertension (-0.08). on outcomes of pregnancy
there was a relationship between S/D and Apgar score, an increase of S/D
was associated with decrease of Apgar score, (-0.16,95% CI=-0.27 to
0.05, p-value=0.06). Conclusion: Oral use of nifedipine as an
antihypertensive of choice in managing hypertensive disorders of
pregnancy seem to improve uteroplacental perfusion in women with
hypertensive disorders of pregnancy.