Conflicting results have been found regarding the effect of nifedipine on uterine blood flow, with detrimental effects on placental perfusion and fetal oxygenation being confirmed in some animal experiments, but not in othersIn summary, our and previous studies suggest that nifedipine decreases the uterine artery PI while alterations in umbilical artery Doppler parameters are minimal and are not sustained. Nifedipine inhibits lower esophageal (LES) muscle contraction by blocking cellular calcium uptake and lowers the LES resting pressure by 30% to 60%; side effects (e.g., hypotension, headache, dizziness) and tolerance may limit its utility. In rats nifedipine exacerbates both the antihypertensive actionMarked hypotension with magnesium sulphate and nifedipine has been reported. Blood‐flow resistance decreases in the uterine circulation. In a primate model, maternal heart rate and blood pressure are unaffected, while fetal blood pressure is elevatedOur study has shown that nifedipine maintenance tocolysis is associated with a significant decline in uterine artery and middle cerebral artery Doppler indices 24 h after the first dose. Histological changes are detectable as early as 10 minutes after the onset of severe hypertension, and clinically apparent arteriolar damage is seen within a few hoursA number of drugs have been used in pregnancy to treat hypertension in pregnancy. 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