Sodium nitroprusside for control of severe hypertensive disease of pregnancy: a case report and discussion of potential toxicity.

Sodium nitroprusside has been used to alter blood pressure in severe hypertensive disease of pregnancy; however, concern exists in regard to potential lethal complications from cyanide toxicity in both mother and fetus. We recently evaluated levels of cyanide in the liver of an infant stillborn to a woman in whom sodium nitroprusside was used to control gestational hypertension secondary to mitral valve disease. The fetal liver demonstrated levels of cyanide below toxic ranges. Biologic activity, potential toxicity, and treatment of toxic symptoms of nitroprusside are discussed.