A study of oral Nifedipine and intravenous Labetalol in severe hypertension in pregnancy at teaching hospital
Journal Title: International Archives of Integrated Medicine - Year 2017, Vol 4, Issue 8
Abstract
Background: Hypertensive disorders of pregnancy, including preeclampsia, complicate up to 10% of pregnancies worldwide, constituting one of the greatest causes of maternal and perinatal morbidity and mortality worldwide. Aim: To compare intravenous Labetalol with oral Nifedipine in their rapidity to control hypertensive emergencies of pregnancy. Materials and methods: Pregnant woman with severe gestational hypertension ≥ 160/110 mm of Hg were randomized to receive intravenous Labetalol injection (in an escalating dose regimen of 20, 40, 80, 80 and 80 mg) or Nifedipine (10mg tab orally upto 5 doses ) until the target blood pressure of 150/90mm of Hg was achieved. Crossover treatment was effected if the initial treatment regimen was unsuccessful. Results: Mean time required 47 ± 14 mins in the Labetalol groups and 45 ± 15minutes in the Nifedipine group. This comparison showed no difference in the two groups with a ‘P’ value of >0.05. The mean amount of drugs required to achieve BP 150/90mm of Hg were 96 ± 38in the Labetalol group and 23 ± 13mg in the Nifedipine group. And this comparison showed no difference statistically with a ‘P’ value of >0.05. Most of the patients were controlled by 2 doses of each drug, 56% in the Labetalol group and 62% in the Nifedipine group. 12% and 14% in the Labetalol and Nifedipine group respectively were not controlled by 5 doses of either drug and required crossover drug therapy. Most of the patients were controlled by two doses of each drug, 50% in the Labetalol group and 60% in the Nifedipine group. 12.5% and 17.5% in the Labetalol & Nifedipine group respectively were not controlled by 5 doses of either drug andrequires crossover drug therapy. Conclusions: Labetalol is both effective and safe in severe HTN.ACOG recommends labetalol as an appropriate first line treatment in severe HTN in pregnancy.
Authors and Affiliations
A. Padmaja, V. Lakshmi Sravanthi
Keywords
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