Nicardipine Versus Nifedipine for Postpartum Hypertensive Emergencies in Severe Preeclampsia

Severe preeclampsia (sPE)-induced postpartum hypertensive emergencies (PHEs) pose a threat to maternal safety, requiring rapid and stable blood pressure (BP) control. This protocol describes an observational, non-randomized controlled cohort study designed to evaluate the efficacy and safety of two calcium channel blockers-nicardipine (NIC) and nifedipine (NIF)-in patients with sPE-induced PHEs. Key procedural steps include: retrospective enrollment of 131 eligible patients (67 in the NIC group, 64 in the NIF group) admitted between April 2024 and May 2025; propensity score matching to balance baseline characteristics (e.g., age, gestational age, baseline BP); standardized routine sPE management plus targeted antihypertensive treatment (NIC via continuous intravenous infusion, NIF via oral immediate-release tablets); and systematic monitoring of predefined endpoints (BP control metrics, hemodynamic parameters, biological markers including brain natriuretic peptide [BNP] and D-dimer, adverse events, and short-term maternal outcomes). Statistical analyses will use SPSS 32.0, with appropriate tests for between-group comparisons and covariance analysis to adjust for confounding. This protocol is intended to provide a standardized workflow for comparing the two agents in real-world clinical settings, to inform individualized PHE management-particularly regarding drug selection based on clinical context (e.g., venous access availability, monitoring resources)-and to support evidence-based decision-making for postpartum hypertensive crisis care.