Use of Intravenous Clevidipine in the Management of Severe Preeclampsia: A Case Report

Severe preeclampsia is a hypertensive disorder of pregnancy that poses significant risks to both maternal and fetal health. First-line antihypertensives such as labetalol, hydralazine, and nifedipine are widely used; however, alternative agents may be considered in refractory cases. Clevidipine, an ultrashort-acting intravenous dihydropyridine calcium channel blocker, offers rapid titratability and is used in critical care settings, although its use in pregnancy remains understudied. We present a case of successful clevidipine use in a patient with severe preeclampsia refractory to standard therapy, highlighting its potential role in obstetric hypertensive emergencies. Clevidipine was selected due to its rapid onset, short half-life, and capacity for precise, titratable blood pressure control. Additionally, its metabolism by blood and tissue esterases, independent of hepatic or renal function, makes clevidipine advantageous in preeclampsia, where hepatic and renal dysfunction are often part of the disease process. Its rapid titratability also allows prompt discontinuation following spinal anesthesia, preventing prolonged hypotension that may result from non-titratable agents.