Due to the increased tone of the uterus and cardiovascular pathologies, childbirth can begin earlier than necessary. To preserve the pregnancy and improve the general condition of the expectant mother, the doctor may prescribe Nifedipine. Such a medicine has worked well. with increased blood pressure and angina pectoris, but while carrying a child, its use requires increased caution and medical supervision.
Features of the drug and its action
Nifedipine is available in tablet form by several pharmaceutical companies. They are sold in blisters and polymer cans of 10, 20 or more. One tablet contains 10 mg of the active substance, which is also called nifedipine. Auxiliary components of the drug are talc, gelatin, cellulose, lactose and other compounds, due to which the tablet is dense (the list of these components differs from different manufacturers).
The drug belongs to calcium channel blockers, since this is its main mechanism of action, due to which calcium enters smooth muscle cells more slowly. The consequence of the effect on such cells in the vascular walls will be a decrease in vascular tone, which leads to a hypotensive effect and expansion of the arteries. Antianginal action of "Nifedipine" is due to its effect on cardiomyocytes and coronary vessels.
During pregnancy, the effect of the active ingredient of the tablets on the smooth muscles of the uterus is in demand, therefore the drug is used for tocolysis - suppression of contractions if they began earlier than expected. Under the influence of "Nifedipine", the frequency and amplitude of contractions rapidly decreases, the basal tone of the myometrium decreases.
When is it prescribed for expectant mothers?
The use of "Nifedipine" during pregnancy is often in demand at risk of giving birth ahead of schedule. Premature labor is considered to have begun at a gestation period of 28–37 weeks, when the fetus has not yet gained the required mass, and the baby's lungs are not yet ripe for independent functioning. The birth during this period is fraught with serious pathologies and even the death of a baby, so doctors are trying to stop contractions with medication. And "Nifedipine" showed itself well as a tocolytic, and also provoked side effects much less often than other means for relaxing the muscular membrane of the uterus.
This drug is often chosen if the expectant mother has high blood pressure and signs of preeclampsia.
Is it allowed during pregnancy?
In the annotation to the tablets, you can read that "Nifedipine" is prohibited during the period of gestation. However, both in our country and abroad, this drug has been used during pregnancy for several decades. It is assigned to category C, because in the early stages it can provoke abnormalities in the development of the embryo (side effects have been identified in animals). Therefore, in the 1st trimester, "Nifedipine" is not prescribed to women in position.
The medication is allowed to be used during pregnancy not earlier than the 16th week, when the risk of exposure to the fetus decreases... There are no studies on the effect of such a drug on pregnant women, but the expected benefits of Nifedipine may, despite all the risks, justify the use of such a drug. Foreign doctors recognize the benefits of using "Nifedipine" for pregnant women who have abnormalities in the state of the cardiovascular system.
In our country and neighboring countries, such a medicine and its analogues in terms of the active substance are also in demand for diseases of the heart and blood vessels, as well as with increased uterine tone in the 2nd and 3rd trimesters. In the first 14-15 weeks of pregnancy, such a medicine is prohibited, since even its potential benefit does not outweigh the risk to fetal development. During the period when the organs of the crumbs are just beginning to develop, "Nifedipine" can become that negative external factor that will lead to the following deviations:
- the appearance of congenital abnormalities in the fetus;
- lag in development and growth;
- violation of the functions of the internal organs of the child;
- fading pregnancy.
From 16 and 17 weeks, medications no longer pose such a serious threat to the baby as in the first trimester, therefore, when it comes to preserving the pregnancy, the appointment of "Nifedipine" is justified. In the case of hypertonia, the fetus may suffer from hypoxia, and the risk of pregnancy fading increases.
Therefore, if you have cramping abdominal pain and bloody discharge, it is important to see a doctor right away. At a later date, the specialist will first conduct an examination, assess the woman's condition. If treatment with Nifedipine is beneficial, such a drug will be prescribed.
Contraindications
The use of "Nifedipine" is prohibited not only in early pregnancy, but also in situations such as:
- if the expectant mother has low blood pressure (with hypotension with systolic blood pressure below 90 mm Hg);
- if a woman is diagnosed with severe heart disease, which led to heart failure;
- if the patient has aortic stenosis;
- if a woman does not tolerate Nifedipine or any auxiliary ingredient of the tablets.
Severe violations of the liver or kidneys in the expectant mother are the reason for more careful monitoring of the patient's condition during treatment.
In case of serious diseases of these organs, taking "Nifedipine" is permissible only in a hospital, and high dosages are contraindicated. The reason for monitoring the reaction to the drug should also be diabetes mellitus, hypovolemia, hemodialysis, circulatory disorders in the brain and some other problems.
Side effects
While taking "Nifedipine", there may be side effects such as:
- a slight increase in the frequency of heart contractions;
- feeling of palpitations;
- redness of the skin;
- flushing of the face;
- feeling of warmth;
- lowering blood pressure;
- swelling of the limbs;
- increased activity of liver enzymes;
- nausea;
- liquefaction of the stool;
- heartburn;
- headache;
- skin rash and other allergic reactions.
When these or any other negative symptoms appear, you should immediately consult a doctor who must determine whether the drug needs to be canceled, and also select an adequate replacement.
How to use?
The scheme of use, single dosage, frequency of taking pills and duration of treatment are determined individually, although instructions for use are attached to the drug. The doctor takes into account the history and condition of the woman, the duration of pregnancy, the presence of concomitant pathologies. It is strictly forbidden to start drinking "Nifedipine" on your own, to arbitrarily change the dose or to cancel the medication, since such actions can result in irreversible consequences for the baby and the expectant mother.
The drug can be used for several days or several weeks. The exact course of treatment is determined by the attending physician. The drug is taken orally after meals, washed down with plain water. In case of angina pectoris or high blood pressure, the tablet should be sucked under the tongue. If the medicine is swallowed, then for a faster therapeutic effect, it is permissible to chew the tablet.
Important! After taking it, it is best to stay in a supine position for some time, since a decrease in blood pressure is one of the most common side effects when using Nifedipine. As a rule, such a side effect does not greatly interfere with expectant mothers, since with the threat of termination of pregnancy, they observe bed rest.
The withdrawal of the medication should be gradual. If you stop taking the pills abruptly, you may develop withdrawal symptoms. As for drug interactions, there are many restrictions for the use of "Nifedipine", for example, if you take such a medication together with beta-blockers, you can cause a strong drop in blood pressure and even provoke heart failure. Compatibility with "Nifedipine" drugs, which are already taking a pregnant woman, should be clarified before starting treatment.
Reviews
Women who were prescribed "Nifedipine" while carrying a child leave mostly positive reviews about it. They emphasize the effectiveness of the drug for maintaining pregnancy, especially if the expectant mother has high blood pressure. Its pluses include low price and availability, and among the minuses, the occurrence of side effects is usually mentioned.
Analogs
The analogues of "Nifedipine" in terms of the active substance include "Cordipin", "Corinfar", "Cordaflex", "Adalat" and other drugs. All of them can be used exclusively under the supervision of a specialist. The choice of such a remedy to replace "Nifedipine" must be coordinated with your doctor. If it is necessary to prescribe to a pregnant woman a drug that can replace "Nifedipine", take into account the clinical picture, gestation period and the patient's condition. Depending on the indications, the doctor may prescribe several analogs.
- "Ginipral"... Such an injection solution is injected into a vein if there is a threat of premature birth or miscarriage, as well as in case of problems during delivery. The medication is contraindicated until the 22nd week, and at a later date it is used only under the supervision of doctors with strict indications.
- "Utrozhestan". The use of these capsules is possible at any stage of pregnancy with a high risk of abortion or early birth. The action of the drug determines progesterone, therefore, "Utrozhestan" is prescribed in cases when the amount of such a hormone in the body of the expectant mother is lowered.
- "No-shpa"... Such a remedy is able to relax smooth muscles, therefore, it is in demand with uterine tone, especially in the early stages. However, in the second and third trimesters, pills and injections are prescribed with caution to prevent premature birth.
- "Traktocil". This solution affects receptors that are sensitive to oxytocin. And therefore, the medication can stop contractions, but does not have a harmful effect on the heart. Injections are used for a period of 24 to 34 weeks, if the uterus begins to contract regularly, but the disclosure is less than 3 cm.
