Efficacy of nitroglycerine infusion versus sublingual nifedipine in severe pre-eclampsia: A randomized, triple-blind, controlled trial
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1. Information regarding the use of continuous i.v. administration of nitroglycerine as an antihypertensive agent in the management of pre-eclampsia is scarce. In the present study, i.v. nitroglycerine or sublingual nifedipine were administered to 32 women with severe pre-eclampsia who were being managed with controlled plasma volume expansion and MgSO4 loading and maintenance doses. Maternal blood pressure and heart rate responses, fetal heart rate responses and perinatal fetal-maternal adverse effects were evaluated using classical parametric and non-parametric data analysis and data modelling by mixed models. 2. An important hypotensive response was observed in both groups, although this reponse was greater, faster and exhibited less variability (more precision) in the nitroglycerine-treated group. Heart rate also increased in both the nitroglycerine- and nifedipine-treated groups (4.6 ± 4.4 vs 8.6 ± 5.3 b.p.m., respectively), although the increase in the nifedipine-treated group was almost twofold that in the nitroglycerine-treated group. There were no significant changes in fetal heart rate in response to vasodilator therapy. The frequency of perinatal fetal-maternal adverse effects was similar in both groups at 40%25 and the adverse effects observed included flushing, headache, palpitations and nausea. 3. In conclusion, i.v. infusion of nitroglycerine is an effective, safe and alternative therapy for severe pre-eclampsia. © 2007 The Authors.
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Antihypertensive therapy; Nifedipine; Nitroglycerine; Severe pre-eclampsia antihypertensive agent; glyceryl trinitrate; magnesium sulfate; nifedipine; vasodilator agent; adolescent; adult; antihypertensive activity; article; blood pressure measurement; clinical article; clinical trial; continuous infusion; controlled clinical trial; controlled study; disease severity; drug efficacy; drug safety; female; fetus heart rate; headache; heart palpitation; heart rate; hot flush; human; nausea; perinatal period; plasma volume; preeclampsia; randomized controlled trial; treatment response; Administration, Sublingual; Adult; Female; Humans; Injections, Intravenous; Magnesium Sulfate; Nifedipine; Nitroglycerin; Pre-Eclampsia; Pregnancy; Time Factors; Vasodilator Agents
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