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Q. Nifedifine taken for irritable uterus and contractions during pregnancy causes low blood pressure. Please help.

Answered by
Dr. Keeranmayee Mishra
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Aug 12, 2020

Hello doctor,

I am a 34-year-old woman. Currently, I am 23 weeks pregnant. I have a very irritable uterus. I had it with my previous pregnancy as well but managed to get to term with the help of a cerclage and IV medication. Right now, I do not have a cerclage though and I am not taking medicines but oral progesterone. My doctor wants to watch and wait this time around.

These past days I have been having lots of contractions and my doctor prescribed Nifedipine 20 mg slow-release tablets to take when needed. I never took one so far but I want to take one tablet now. However, I am a bit worried that my blood pressure is rather low (92-99/53-60) after multiple measurements over several days.

Is it safe to take Nifedipine with this blood pressure? My doctor is on vacation at the moment and has not replied my messages.

Dr. Keeranmayee Mishra

Obstetrics And Gynaecology
#

Hi,

Welcome to icliniq.com.

It must be tough on you, do not worry. I will try to help.

1. Please try to shift to the vaginal route of progesterone as evidence suggests that is it is more effective than the oral route.

2.If contractions are not subsiding take a Nifedipine tablet after food and add a pinch of salt to curry once in a while.

3. If possible, get your cervical length assessed by ultrasound via vaginal route. If it is more than 25 mm there is nothing to worry about. You can wait and try medicines but if less than that and owing to the history of the previous cerclage, you can take an informed decision to undergo cerclage again.

4. There is another injection called Proluton depot (Hydroxyprogesterone caproate). That also helps to prevent preterm labor if taken until 32 to 34 weeks.

5. Take adequate rest and avoid intercourse (just general advice).

6. Still, if the pain does not reduce, please see a doctor as clinical examination might be needed.

7. Nifedipine is not to be taken if systolic BP remains below 90 mmHg.

I hope this helps.


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Thank you doctor,

I will try progesterone vaginally but it usually irritates my vagina. I measured the cervical length one week ago and it was 4.1 cm. However, since then, more contractions started. I will look into Proluton and ask my doctor when I can reach him. I am currently on modified bed rest and do not have any intercourse. I usually lie on my left side for most of the day.

As long as my systolic is over 90 before taking Nifedipine, is it fine to take a tablet? What if after taking it the systolic goes lower say 82-85? Is that normal or acceptable?

Dr. Keeranmayee Mishra

Obstetrics And Gynaecology
#

Hello,

Welcome back to icliniq.com.

Do not repeat Nifedipine doses unless required. You can take it if systolic BP is more than 90 mm at least and then do not repeat if contractions subside. If BP falls then take lemon juice with a pinch of salt.

I hope this helps.


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