Nifedipine in the treatment of severe preeclampsia

Article Abstract:

Preeclampsia is a complication of pregnancy that is characterized by high blood pressure, headaches, protein in the urine, and edema (fluid retention). Nifedipine and hydralazine, two drugs used to treat high blood pressure, were given to 24 and 25 patients, respectively. The patients were between 26 and 36 weeks pregnant and an average of 30 years old, with severe preeclampsia. The purpose of the study was to determine the effectiveness of the two drugs in reducing blood pressure and limiting unwanted side effects on the mother and baby. Neither drug produced any major side effects in the mothers, but acute fetal distress developed in one subject on nifedipine and 11 subjects on hydralazine. Blood pressure was effectively controlled in almost 96 percent of patients (23 of 24 cases) who received nifedipine and only 68 percent of patients (17 of 25 cases) who were given hydralazine. No congenital malformations were identified in either drug-treated group. The birth weights and gestational ages of infants whose mothers received nifedipine were greater, but not significantly greater, than those of infants whose mothers received hydralazine. In this study, nifedipine treatment to control the high blood pressure of severe preeclampsia was effective and safe and may have allowed for a longer gestation, which results in the delivery of a more mature infant, than treatment with hydralazine. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Maternal-fetal exchange, Preeclampsia, Hydralazine, Nifedipine, Calcium channel blockers

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Maternal lithium therapy and polyhydramnios

Article Abstract:

Lithium, a drug used for treating bipolar affective disorders (manic-depressive disease), is known to cause birth defects. This drug is also associated with diabetes insipidus, which involves excessive production of urine due to inadequate secretion of antidiuretic hormone. Since many women of childbearing age take lithium, its potential effect upon the fetus needs to be understood. A case report is provided of a 23-year-old woman under treatment with several psychoactive drugs, including lithium carbonate. After interrupting all drugs at the ninth week of gestation, she resumed taking lithium at 18 weeks and continued until delivery at 34 weeks. Examination during pregnancy revealed polyhydramnios (an excess of amniotic fluid, in which the fetus floats), and labor was induced when the mother developed high blood pressure, protein in the urine, and other pathologic signs. The infant was normal, with the exception of defects in the thoracic spine. Also, his rate of urine excretion was far above normal, suggesting that diabetes insipidus may have been produced as a result of the mother's lithium use. Since lithium is cleared from the circulatory system very slowly during delivery, a withdrawal or decrease in dosage seven to ten days before delivery is currently recommended. This complication of lithium therapy for pregnant mothers should be considered by clinicians. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Complications and side effects, Human embryo, Lithium, Lithium (Metal), Teratogenic agents, Perinatal pharmacology

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Vitamin B6 is effective therapy for nausea and vomiting of pregnancy: a randomized double-blind placebo-controlled study

Article Abstract:

During the first trimester (first three months) of pregnancy, women often experience episodes of nausea and vomiting. Early studies indicated that doses of vitamin B6 could help alleviate these symptoms, although no substantive proof of this effect existed. The use of vitamin B6 to alleviate nausea and vomiting caused by pregnancy was assessed in a well-controlled study that included 59 women who were in early pregnancy. One 25 milligram vitamin B6 tablet was taken three times a day for three days by 31 of the women, while the other 29 were given a placebo. Records of nausea and vomiting were kept during the study period. Prior to the testing, 12 women in the B6 group and 10 in the placebo group rated their nausea symptoms as severe. After treatment, only 1 in the B6 group and 5 in the placebo group reported severe nausea, a significant improvement in the treatment group over the placebo group. For women with less severe nausea, no significant changes in nausea were noted after treatment. In addition, of all the women who had previously experienced vomiting, fewer women in the B6 group reported vomiting at the end of the study. These results indicate that vitamin B6 therapy during early pregnancy can help reduce severe nausea and decrease vomiting. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Vitamin B6, Pyridoxine, Morning sickness (during pregnancy), Morning sickness

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