THEME: Nifedipine Side Effects during Nifedipine Tocolysis for more THan 48 Hours and the Psycological Support Importance in their Management

Background: During the study period June 2012-June 2016 , we have noticed that nifedipine, due to its vasodilating properties can induce to severe or moderate :hypotension, tachycardia (maternal/fetal), headache, nausea, hot flushes, palpitations, even pulmonary edema.In about 98%of cases treated with nifedipine we have prolongated tocolysis for more than 48 hours , so that we have studied its side effects during all the tocolysis time. Several nifedipine side effects can be minimized or better tolerated if we applicate psycologic support and fluid diet.

Patients: Women presenting with preterm labour ( 22- 34 weeks of gestation) between JUNE 2012 and Jun 2016.

Main outcome Measures: Maternal heart rate, blood pressure,and foetal heart rate were monitored regularly. We obsreved fetal growth, fluximetria and biofisic profile.

Results: During the period of our study( JUNE 2012-JUNE 2016) , In 429 cases, preterm labour was suppressed for more than 48 hours. Treatment was discontinued in 2 women because of profound hypotension (<90/60 mmHg) and in 3 women because of severe hedache. Only 9 patients developed maternal tachycardia (≥140 beats per minute), and in 4 foetal tachycardia (≥180 beats per minute) was encountered.

Moderate headache was experienced in100 women , flushing in 29, dizziness in 14 women, nausea in 3, and shortness of breath in 1. There was one case with Dermatitis (on the palmar surface of the hands).

Conclusion: In general, use of nifedipine as the first-line tocolytic was safe. However, severe maternal hypotension and severe headache can occur and close monitoring of vital signs is warranted. The psychological support and fluid diet rregimen have a good impact in the good management of side effects and in the sucsses of the treatment.