Nifedipine in the treatment of severe preeclampsia.

We conducted a randomized clinical trial in which patients with severe preeclampsia between 26-36 weeks of gestation received either nifedipine (10-30 mg sublingually, then 40-120 mg/day orally; N = 24) or hydralazine (6.25-12.5 mg intravenously, then 80-120 mg/day orally; N = 25). Effective control of blood pressure was achieved with nifedipine in 95.8% of subjects and with hydralazine in 68%, a statistically significant difference (P less than .05). Maternal side effects were minor in both groups. Acute fetal distress developed in one nifedipine subject and in 11 treated with hydralazine. Mean prolongation of gestation was 15.5 +/- 10 days with nifedipine and 9.5 +/- 11 days with hydralazine, a difference that did not reach statistical significance (P less than .07). Infants born to women treated with nifedipine were delivered at more advanced gestational ages (34.6 +/- 2.3 versus 33.6 +/- 2.4 weeks; statistically not significant), weighed more (1826 +/- 456 versus 1580 +/- 499 g; statistically not significant), and tended to have fewer, mainly minor, complications. The average number of days spent in the neonatal intensive care unit was significantly lower in the nifedipine group (15.1 versus 32.7 days; P less than .005), leading to an average 31% reduction in total (maternal and neonatal) hospitalization-related charges for each nifedipine-treated pregnancy. We conclude that nifedipine is an effective, convenient, and low-cost treatment for patients with severe preeclampsia, and is not associated with undesirable side effects.

The use of calcium channel blockers in obstetrics and gynecology; a review.

Since their introduction, calcium channel blockers gained wide use in the treatment in various fields of medicine. Calcium channel blockers were shown to inhibit contractions of the pregnant and nonpregnant uterus, and lately their properties have made it, theoretically, an ideal candidate for the use in severe pregnancy-induced hypertension: it is effective in lowering blood pressure, has a fast and long-standing action, may be conveniently administered via the oral route, and it is not associated with serious side effects.

Antenatal maceration of umbilical cord; a case report.

Complete intrapartum detachment of umbilical cord at an area of maceration is described. A severely asphyxiated infant was delivered. Antenatal maceration of umbilical cord has not yet been described. The etiology of the maceration remains obscure.

The ABO, Lewis or P blood group phenotypes are not associated with recurrent pelvic inflammatory disease.

An assumption that ABO, Lewis, or P blood group phenotypes are associated with recurrent pelvic inflammatory disease (PID) in a similar way as with recurrent urinary tract infection has been tried to establish. Of 20 patients with PID 9 (45%) had blood type A, 6 (30%) type B, 1 (5%) type AB and 4 (20%) type O; 14 (70%) had Le(a-b+), 5 (25%) had Le(a+b-), and 1 (5%) had Le(a-b-). Of the 20 controls 10 (50%) had blood type A, 3 (15%) type B, 1 (5%) type AB and 6 (30%) type O; 12 (60%) had Le(a-b+), 4 (20%) had Le(a+b-), and 4 (20%) had Le(a-b-). The difference in the proportions of the A, B, AB, and O phenotypes as well as the proportion of combined recessive and nonsecretor phenotype Le(a+/-b-) between patients with recurrent PID and controls were not statistically significant. The distribution was consistent with that in the general population. 2 of the patient group (10%) and 6 (30%) of the controls had positive blood type P1 (Fisher's exact probability = 0.0958). The distribution of P1 between the patients and controls was opposite to that in the general population. We could not demonstrate association of ABO, Lewis or P blood group phenotypes with recurrent PID.

Effect of nifedipine on fetal heart rate in the treatment of severe pregnancy-induced hypertension.

The effect of lowering the maternal blood pressure with sublingual nifedipine on the fetal heart rate was studied in 51 patients with severe pregnancy-induced hypertension. No fetal heart rate abnormalities were observed, while achieving an excellent control of blood pressure.