![]() ![]() ![]() 3 The general consensus recommends that persistent severe hypertension must be treated to reduce maternal mortality and morbidity. 2 Among women with antepartum severe hypertension, the incidence of maternal adverse events exceeds 25%. 1 Women with pre-eclampsia and their (unborn) children are at increased risk of developing serious morbidity. Pre-eclampsia and other hypertensive disorders are responsible for 14% of all maternal deaths worldwide, so these conditions comprise the second leading direct cause of maternal mortality. Nicardipine is safe for treating severe hypertension in pregnancy it reduces blood pressure rapidly and effectively. Based on its high success rate and acceptable safety profile, nicardipine should be considered a first-line treatment in women with severe hypertension in pregnancy. We found that nicardipine could effectively and safely treat this condition. To date, this was the largest case-series study on the use of nicardipine for treating severe antepartum hypertension in pregnancy. During treatment, headache, nausea, and vomiting decreased significantly. One case of fetal distress was attributable to maternal hypotension, and a cesarean section was performed at more than 2 h after initiating therapy. In all cases, the low DBP resolved after discontinuing or reducing the dosage of nicardipine. Within the first 2 h, 42.7% of women experienced temporary low DBP (ie below 70 mm Hg) without clinical consequences for the mother or fetus. In all cases, nicardipine was eventually effective. Within 2 h of treatment, 77.4% of women achieved successful treatment. In three out of four women, the mean arterial pressure was below 120 mm Hg. After 1 h of treatment, two-thirds of the women had SBP below 160 mm Hg and DBP below 100 mm Hg. Severe hypertension was defined as systolic blood pressure (SBP) of 160 mm Hg or more and/or diastolic blood pressure (DBP) of 110 mm Hg or more. Primary outcome measures: successful treatment, time to successful treatment, and maternal safety. This multicenter, retrospective case series included all pregnant women beyond 20 weeks of gestation with severe antepartum hypertension that were treated with intravenous nicardipine. The present study evaluated the intravenous use of the calcium antagonist, nicardipine. It remains unknown which antihypertensive is best suited for pregnancy. Women with severe hypertension during pregnancy require prompt stabilization with a combination of magnesium sulfate and rapidly acting intravenously administered antihypertensives. ![]()
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