The effect of nifedipine and methyldopa on maternal cerebral circulation
Abstract
To study how the treatment of severe gestational hypertension affects maternal middle cerebral artery velocimetry. Prospective, clinical, descriptive study. John Radcliffe Maternity Hospital, Oxford, England. Pregnant and puerperal women who required acute or chronic antihypertensive treatment with nifedipine (n = 46) or methyldopa (n = 26), respectively. Transcranial Doppler ultrasound examinations of maternal middle cerebral arteries were performed before and 45 min after nifedipine; and before and 48 hours after the onset of methyldopa therapy. Blood pressure and heart rate were also recorded. Clinical and transcranial Doppler changes induced by the antihypertensive medication. Blood pressure and middle cerebral artery velocities decreased significantly following both short- and long-acting antihypertensive therapy. Nifedipine-induced changes were more pronounced and uniform than those found after methyldopa (16.7% and 6.4% decrease in middle cerebral artery mean velocity, respectively). The middle cerebral artery mean velocity decrease was independent of changes in the blood pressure or heart rate. Maternal cerebral haemodynamics are influenced by antihypertensive treatment. The reduction of middle cerebral artery flow velo...Continue Reading
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Ophthalmic artery Doppler analysis: a window into the cerebrovasculature of women with pre-eclampsia
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