Does sodium nitroprusside kill babies? A systematic review

Authors

  • Nelson Sass Universidade Federal de São Paulo — Escola Paulista de Medicina
  • Caroline Harumi Itamoto Universidade Federal de São Paulo — Escola Paulista de Medicina
  • Marina Pereira da Silva Universidade Federal de São Paulo — Escola Paulista de Medicina
  • Maria Regina Torloni Universidade Federal de São Paulo — Escola Paulista de Medicina
  • Álvaro Nagib Atallah Universidade Federal de São Paulo — Escola Paulista de Medicina

Keywords:

Nitroprusside, Fetal death, Fetal mortality, High-risk pregnancy, Hypertension

Abstract

OBJECTIVE: To determine whether sodium nitroprusside causes fetal death in pregnancies complicated with hypertension. DATA SOURCES: Medical Literature Analysis and Retrieval System Online (MEDLINE; 1996 to 2003), Excerpta Medica (EMBASE; 1970 to 2003), Web of Science/Institute for Scientifi c Information (ISI; 1945 to 2003), Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS; 1982 to 2003) and the Cochrane Library. REVIEW METHODS: The medical subject headings used were “nitroprusside and pregnancy”, “hypertension or eclampsia or preeclampsia” and “nitroprusside and pregnancy and hypertensive emergencies”. The search was limited to humans and female gender, in all fi elds, publication types, languages and subsets. Articles were also identifi ed by reviewing the references of articles and textbooks on hypertension and pregnancy. RESULTS: The search located nine studies. The sum of all the publications yielded a total of 22 patients and 24 exposed fetuses (two pairs of twins). There were no randomized clinical trials and no prospective cohorts. All of the studies were observational in nature. CONCLUSIONS: At present, there is insuffi cient evidence for defi nitive conclusions about any direct association between sodium nitroprusside use and fetal demise.

Downloads

Download data is not yet available.

Author Biographies

Nelson Sass, Universidade Federal de São Paulo — Escola Paulista de Medicina

PhD. Professor of Obstetrics, Universidade Federal de São Paulo — Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.

Caroline Harumi Itamoto, Universidade Federal de São Paulo — Escola Paulista de Medicina

Sixth-year medical student, Universidade Federal de São Paulo — Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.

Marina Pereira da Silva, Universidade Federal de São Paulo — Escola Paulista de Medicina

Sixth-year medical student, Universidade Federal de São Paulo — Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.

Maria Regina Torloni, Universidade Federal de São Paulo — Escola Paulista de Medicina

MD. Medical staff, Universidade Federal de São Paulo — Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.

Álvaro Nagib Atallah, Universidade Federal de São Paulo — Escola Paulista de Medicina

MD, PhD. Professor of Evidence-Based Medicine and Director of the Brazilian Cochrane Center, Universidade Federal de São Paulo — Escola Paulista de Medicina (Unifesp-EPM), São Paulo, Brazil.

References

Allen VM, Joseph K, Murphy KE, Magee LA, Ohlsson A. The effect of hypertensive disorders in pregnancy on small for gestational age and stillbirth: a population based study. BMC Pregnancy Childbirth. 2004;4(1):17.

Henry CS, Biedermann SA, Campbell MF, Guntupalli JS. Spectrum of hypertensive emergencies in pregnancy. Crit Care Clin. 2004;20(4):697-712, ix.

Varon J, Marik PE. The diagnosis and management of hyper- tensive crises. Chest. 2000;118(1):214-27.

Duley L, Henderson-Smart DJ, Meher S. Drugs for treatment of very high blood pressure during pregnancy. In: The Cochrane Database of Systematic Reviews, Issue 1; 2007. Available from: http://www. cochrane.org/reviews/en/ab001449.html. Accessed in 2007 (Feb 12).

Paull J. Clinical report of the use of sodium nitroprusside in severe preeclampsia. Anaesth Intensive Care. 1975;3(1):72.

Donchin Y, Amirav B, Sahar A, Yarkoni S. Sodium nitroprus- side for aneurysm surgery in pregnancy. Report of a case. Br J Anaesth. 1978;50(8):849-51.

Rigg D, McDonogh A. Use of sodium nitroprusside for deliberate hypotension during pregnancy. Br J Anaesth. 1981;53(9):985-7.

Stempel JE, O’Grady JP, Morton MJ, Johnson KA. Use of so- dium nitroprusside in complications of gestational hypertension. Obstet Gynecol. 1982;60(4):533-8.

Willoughby JS. Sodium nitroprusside, pregnancy and multiple in- tracranial aneurysms. Anaesth Intensive Care. 1984;12(4):358-60.

Shoemaker CT, Meyers M. Sodium nitroprusside for control of severe hypertensive disease of pregnancy: a case report and discussion of potential toxicity. Am J Obstet Gynecol. 1984;149(2):171-3.

Baker AB. Management of severe pregnancy-induced hyperten- sion, or gestosis, with sodium nitroprusside. Anaesth Intensive Care. 1990;18(3):361-5.

Mendonça D, Garcia ACG, Gomes EF, et al. Aspectos terapêuti- cos da DHEG na Maternidade do Hospital Universitário Lauro Wanderley. [Therapeutics aspects of DHEG in Lauro Wanderley University Hospital]. J Bras Ginecol. 1994;104(3):71-6.

Nascimento RWC, Vale NB. Tolerância ao efeito anti-hipertensivo do nitroprussiato de sódio na anestesia para cesariana de paciente eclâmptica. Relato de caso. [Acute tolerance to the anti-hypertensive effect of sodium nitroprusside infusion in eclamptic patient anesthe- sia. Case report]. Rev Bras Anestesiol. 1998;48(4):278-82.

Mabie WC. Management of acute severe hypertension and encephalopathy. Clin Obstet Gynecol. 1999;42(3):519-31.

Begum MR, Quadir E, Begum A, Akhter S, Rahman K. Management of hypertensive emergencies of pregnancy by hydralazine bolus injection vs continuous drip--a comparative study. Medscape Womens Health. 2002;7(5):1.

Vigil-De Gracia P, Montufar-Rueda C, Smith A. Pregnancy and severe chronic hypertension: maternal outcome. Hypertens Pregnancy. 2004;23(3):285-93.

Scardo JA, Vermillion ST, Newman RB, Chauhan SP, Hogg BB. A randomized, double-blind, hemodynamic evaluation of nifedipine and labetalol in preeclamptic hypertensive emergen- cies. Am J Obstet Gynecol. 1999;181(4):862-6.

Rey E, LeLorier J, Burgess E, Lange IR, Leduc L. Report of the Canadian Hypertension Society Consensus Conference: 3. Pharmacologic treatment of hypertensive disorders in pregnancy. CMAJ. 1997;157(9):1245-54.

Friederich JA, Butterworth JF 4th. Sodium nitroprusside: twenty years and counting. Anesth Analg. 1995;81(1):152-62.

Clark SL, Cotton DB, Hankins GDV, Phelan JP. Complications of pregnancy-induced hypertension. In: Clark SL, Cotton DB, Hankins GDV, et al, editors. Handbook of Critical Care Obstet- rics. Boston: Blackwell Scientific Publications; 1994. p.123-38.

Naulty J, Cefalo RC, Lewis PE. Fetal toxicity of nitroprusside in the pregnant ewe. Am J Obstet Gynecol. 1981;139(6):708-11.

Ring G, Krames E, Shnider SM, Wallis KL, Levinson G. Comparison of nitroprusside and hydralazine in hypertensive pregnant ewes. Obstet Gynecol. 1977;50(5):598-602.

Wheeler AS, James FM 3rd, Meis PJ, et al. Effects of nitroglyc- erin and nitroprusside on the uterine vasculature of gravid ewes. Anesthesiology. 1980;52(5):390-4.

Lieb SM, Zugaib M, Nuwayhid B, et al. Nitroprusside-induced hemodynamic alterations in normotensive and hypertensive pregnant sheep. Am J Obstet Gynecol. 1981;139(8):925-31.

Nelson SH, Suresh MS. Comparison of nitroprusside and hydralazine in isolated uterine arteries from pregnant and nonpregnant patients. Anesthesiology. 1988;68(4):541-7.

Bobier HS, Smith GN, Pancham SR, Brien JF. Comparative study of sodium nitroprusside induced vasodilation of human placental veins from premature and full-term normotensive and preeclamp- tic pregnancy. Can J Physiol Pharmacol. 1995;73(8):1118-22.

Ellis SC, Wheeler AS, James FM 3rd, et al. Fetal and maternal effects of sodium nitroprusside used to counteract hypertension in gravid ewes. Am J Obstet Gynecol. 1982;143(7):766-70.

Fung HL. Clinical pharmacology of organic nitrates. Am J Cardiol. 1993;72(8):9C-13C; discussion 14C-15C.

Murphy C. Hypertensive emergencies. Emerg Med Clin North Am. 1995;13(4):973-1007.

Pasch T, Schulz V, Hoppelshauser G. Nitroprusside-induced formation of cyanide and its detoxication with thiosulfate during deliberate hypotension. J Cardiovasc Pharmacol. 1983;5(1):77-85.

Hall VA, Guest JM. Sodium nitroprusside-induced cyanide in- toxication and prevention with sodium thiosulfate prophylaxis. Am J Crit Care. 1992;1(2):19-25; quiz 26-7.

Nakamura Y, Yasuda M, Fujimori H, Kiyono M, Pan-Hou H.. Cytotoxic effect of sodium nitroprusside on PC12 cells. Chemosphere. 1997;34(2):317-24.

Gobbel GT, Chan TY, Chan PH. Nitric oxide and superoxide- mediated toxicity in cerebral endothelial cells. J Pharmacol Exp Ther. 1997;282(3):1600-7.

Niknahad H, O’Brien PJ. Involvement of nitric oxide in nitro- prusside-induced hepatocyte cytotoxicity. Biochem Pharmacol. 1996;51(8):1031-9.

Izumi Y, Benz AM, Clifford DB, Zorumski CF. Neurotoxic effects of sodium nitroprusside in rat hippocampal slices. Exp Neurol. 1993;121(1):14-23.

Dicionário de Especialidades Farmacêuticas: DEF 2001/02. 30th ed. Rio de Janeiro: Editora de Publicações Científicas; 2001.

Downloads

Published

2007-03-03

How to Cite

1.
Sass N, Itamoto CH, Silva MP da, Torloni MR, Atallah Álvaro N. Does sodium nitroprusside kill babies? A systematic review. Sao Paulo Med J [Internet]. 2007 Mar. 3 [cited 2025 Mar. 9];125(2):108-11. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2065

Issue

Vol. 125 No. 2 (2007)

Section

Systematic Review

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.