INTRAVENOUS LABETALOL VERSUS ORAL NIFEDIPINE FOR ACUTE BLOOD PRESSURE CONTROL IN SEVERE PREGNANCY-INDUCED HYPERTENSION- A RANDOMISED TRIAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 92
Abstract
BACKGROUND Hypertensive disorders of pregnancy complicate approximately 12% to 22% of all pregnancies. Various complications occur due to hypertensive disorder. Although delivery of the foetus is the definitive treatment yet then there are many drugs available to control the maternal blood pressure. Aim & Objectives- To compare efficacy of intravenous labetalol and oral nifedipine when used rapidly to lower high blood pressure in severe pregnancy-induced hypertension. MATERIALS AND METHODS It is a hospital-based, prospective, interventional, randomised control trial conducted at Chittaranjan Seva Sadan from April 2014 to March 2016. 150 pregnant women in between 34-41 weeks gestation with BP ≥160/110 were recruited for the study. They were randomly allocated into two groups. In group A, intravenous labetalol 20 mg was given and drug was repeated at 20 minutes interval in an escalating dose regimen of 40, 80, 80 and 80 mg to achieve the target blood pressure (BP<150/90). In group B, nifedipine 10 mg was given orally, 20 minutes interval up to a maximum of 5 doses. Maternal parameters studied are amount of drug, time required, crossover treatment, any complication & mode of delivery. Results were analysed with the Student’s t-test and Mann-Whitney U test. RESULTS Most patients belonged to 38-40 weeks gestational age, 80% in the labetalol group & 84% in the nifedipine group. Mean SBP was 180±16 mm of Hg in group A and 170 ± 14 mm of Hg in group B (P=0.669). Mean DBP was 116 ± 8 mm of Hg in group A and 110 ± 8 mm of Hg in group B (P=0.745). The mean dosage of drug required was 94 ± 35.8 mg in group A and 20.8 ± 10.9 mg in group B (P<0.001). The mean time required was 45.2 ± 11.5 minutes in group A and 43.6 ± 12.5 minutes in group B (P =0.511). Most of the patients were controlled by two doses of each drug, 56% in the labetalol group and 61.33% in the nifedipine group. CONCLUSION Intravenous labetalol and oral nifedipine are almost equally effective and well tolerated in acute blood pressure control in severe pregnancy-induced hypertension. However, labetalol seems to be safer, with quicker control of blood pressure with fewer side effects
Authors and Affiliations
Ramprasad Dey, Arunima Mukhopadhyay, Subhash Chandra Biswas, Siuli Chanda Chakrabarti, Joyeeta Monda, Swarnalata Soren
Keywords
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- EP ID EP279227
- DOI 10.14260/jemds/2017/1426
- Views 57
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