Effects of nifedipine on fetal cardiac function in preterm labor

Osman Yilmaz 1  and Ayhan Şule Göncü 2
  • 1 Pediatric Cardiology, University of Health Sciences, Ankara Etlik Zübeyde Hanım Women’s Health Training and Research Hospital, Ankara, Turkey
  • 2 Department of Obstetrics and Gynecology, Clinic of Perinatology, Ministry of Health Ankara City Hospital, Ankara, Turkey
Osman Yilmaz
  • Corresponding author
  • Pediatric Cardiology, University of Health Sciences, Ankara Etlik Zübeyde Hanım Women’s Health Training and Research Hospital, Ankara, Turkey
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and Ayhan Şule Göncü
  • Department of Obstetrics and Gynecology, Clinic of Perinatology, Ministry of Health Ankara City Hospital, Ankara, Turkey
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Abstract

Objectives

To evaluate the effects of nifedipine treatment on fetal hemodynamics and cardiac function during preterm labor. This prospective study assessed several quantitative parameters of fetal cardiac circulation and function, and found no significant changes at 48 h after nifedipine treatment. These findings suggest that tocolytic nifedipine may be safe for fetuses. It supports clinicians to use nifedipine treatment for tocolysis without any cardiac effect on the fetus.

Methods

A prospective cohort study was conducted at a tertiary hospital between January 2016 and October 2017. A total of 45 pregnant women who required nifedipine for preterm labor were included in this study. Fetal Doppler ultrasound was performed and fetal systolic and diastolic function was measured prior to, and 48 h after, the first nifedipine treatment. Conventional Doppler parameters were used to evaluate fetal heart function and hemodynamic changes. Tricuspid annular plane systolic excursion, mitral annular plane systolic excursion and the sphericity index were also evaluated to assess changes in fetal cardiac morphology.

Results

No significant changes in fetal Doppler parameters were observed following nifedipine tocolysis. There was no significant difference in the fetal cardiac function parameters of both ventricles before vs. after nifedipine treatment. Tricuspid annular plane systolic excursion, mitral annular plane systolic excursion, and sphericity index values were unchanged following nifedipine treatment.

Conclusions

Oral administration of nifedipine did not to alter fetal cardiac function or morphology. Fetal cardiac parameters and various Doppler indices were unchanged following nifedipine treatment. Maternal nifedipine treatment does not appear to have any significant effect on fetal cardiac function.

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