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Hemodynamic Changes Associated With Intravenous Infusion of the Calcium Antagonist Verapamil in the Treatment of Severe Gestational Proteinuric Hypertension

From the Departments of Obstetrics and Gynecology and Pediatrics, University of Cape Town Medical School and Groote Schuur Hospital, Cape Town, South Africa

Abstract

The calcium antagonist verapamil was intravenously infused after plasma volume expansion with dextran-70 in nine patients with severe gestational proteinuric hypertension. The hemodynamic response of these patients was monitored using a flow-directed pulmonary artery catheter. Verapamil produced a statistically significant reduction in mean arterial pressure and systemic vascular resistance without adversely affecting the cardiac output. The decrease in blood pressure was smooth and controlled and was associated with an insignificant increase in heart rate. There were no adverse fetal effects as evidenced by cardiotocographic monitoring. The apparent efficacy of verapamil in this study justifies further investigation.