Nicardipine treatment of hypertension during pregnancy.

OBJECTIVE: To assess the effects of nicardipine, a dihydropyridine calcium channel blocker, on the fetus and mother in hypertensive pregnant women.

METHODS: Forty pregnant patients with mild or moderate hypertension received oral nicardipine 20 mg three times a day (mean duration of treatment 9 +/- 2.1 weeks). Twenty patients with severe preeclampsia (diastolic blood pressure greater than 110 mmHg and 24-hour proteinuria greater than 500 mg) received intravenous (IV) nicardipine at 2, 4, or 6 mg/hour according to body weight (mean duration of treatment 5.3 +/- 3.6 days).

RESULTS: Oral nicardipine induced a significant decrease in both systolic and diastolic blood pressures compared with pre-treatment values (P < .001). Intravenous nicardipine decreased diastolic blood pressure below 90 mmHg, at least temporarily, in all 20 patients. Nine patients taking IV nicardipine complained of headaches. Doppler velocimetry remained stable with both oral and IV nicardipine. Neonatal outcome showed no deleterious effect of the treatment.

CONCLUSIONS: Oral or IV nicardipine seems to be safe in hypertensive pregnant patients with the doses used in our study. Assessment of its efficacy will necessitate further clinical randomized trials.