[Comparison of the rate of maternal complications of nifedipine and nicardipine in cases of preterm labor: historical study on two consecutive periods]. / Comparaison de la fréquence des complications maternelles de la nifédipine et de la nicardipine en cas de menace d'accouchement prématuré à membranes intactes : étude historique portant sur deux périodes consécutives.

OBJECTIVES: Calcium channel blockers are the most frequently used tocolytics as first-line in France, frequently intravenously (nicardipine [Loxen(®)]). We would like to compare the side effects of intravenous nicardipine and oral nifedipine. MATERIALS AND METHODS: We performed a restrospective study on two consecutive periods. On the first period (March 2007-September 2008), 110 patients received intravenous nicardipine for preterm labor, and 67 patients received oral nifedipine on the second period (October 2008-January 2010). Side effects were recorded. RESULTS: Patients in the nicardipine-treated group had significantly more side effects (31% versus 16% for nifedipine group, P=0.03). No-administration way related adverse events did not differ between the two groups (P=0.1). There was more low blood pressure in patients treated with nifedipine (P=0.03), but shorter hospital stay (5.4 days versus 7.9 days with nicardipine, P=0.05). CONCLUSION: Using nifedipine simplifies tocolysis administration, and decreases hospital stays without increasing the risk of prematurity.

[Criteria of pregnancy termination in women with preeclampsia]. / Critères d'arrêt de la grossesse en cas de prééclampsie.

Few studies establishing clear criteria for the medical interruption of a pregnancy complicated by PE are available today. Most of these studies are either retrospective or observational. When combining an analysis of the available literature together with the experts' opinions, one can propose the following set of criteria for therapeutic interruption of pregnancy in the setting of PE, which apply mainly for the severe forms of the disease. These criteria can be subdivided into maternal and fetal criteria. Maternal criteria are a severe uncontrollable HT, eclampsia, acute pulmonary edema, retro placental haematoma, oligura (<100 ml in 4 hours) resistant to appropriate fluid expansion, persistent signs of imminent eclampsia (headache or visual disturbances), persistent epigastric pain, HELLP syndrome, new-onset renal failure and a gestation time within the first 24 weeks. The fetal criteria are prolonged and variable fetal heart rate (FHR) decelerations, a short term variability in FHR <3 bpm, a Manning score < or =4 on two separate occasions, severe oligohydramnios, an estimated fetal weight below the 5(th) percentile beyond the 32(nd) week of amenorrhea and an inverted diastolic flow in the umbilical artery beyond the 32(nd) week of amenorrhea. In case of non-severe PE beyond the 36(th) week of amenorrhea, interruption of the pregnancy must be considered.