A Study of IV Labetalol Versus Oral Nifedipine in Severe Hypertension in Pregnancy (A prospective randomized comparative study)
Keywords:
hypertension in pregnancy, intravenous labetolol, oral nifedipineAbstract
Introduction: Hypertensive disorders are most common medical complication of pregnancy with incidence ranging 2-8% of all pregnancies and are important cause of maternal and perinatal morbidity and mortality. Aims & Objectives: To compare the efficacy of intravenous labetalol and oral nifedipine in acute blood pressure control in severe hypertension in pregnancy. Material & Methods: A randomized controlled study was conducted in the Department of Obstetrics and Gynaecology, Govt. Medical College and Rajendra Hospital, Patiala. Total 100 subjects with gestation ≥ 28 weeks with blood pressure ≥ 160/110 mm of Hg were included in study and randomized equally in two groups. Group A received intravenous labetalol in escalating doses of 20 mg, 40 mg, 80 mg and 80 mg every 15 minutes and Group B received oral nifedipine in doses of 10 mg, 20 mg and 20 mg every 20 minutes until blood pressure of ≤150/100 mm of Hg was achieved. Cross over treatment was administered if the initial treatment failed. The time required achieve target blood pressure and adverse effects were noted. The statistical value of significance was taken as p˂0.05. Results: The time required to achieve target blood pressure in Group A (Labetalol) was 30.00±13.89 minutes and in Group B (nifedipine) was 34.00±14.14 minutes with p value 0.512. The adverse effects noted with both the drugs were very few and of minor degree with no statistical difference. Conclusion: We concluded, Intravenous labetalol and oral nifedipine are equally effective in the control of severe hypertension in pregnancy.
Downloads
References
Kumari VR, Saraswathi K, Srilaxmi A. Oral nifedipine versus intravenous labetalol for control of blood pressure in severe preeclampsia. J. Evolution Med. Dent. Sci. 2016; 5 (20):994-7.
Alam A and Zakaria S.M.A. Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomized controlled trial. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2019 May ; 8(5):1921-7
Gestational hypertension and preeclampsia. ACOG Practice Bulletin No. 202. American College of Obstetricians and Gynecologists. Obstet Gynecol 2019;133: e1–25.
Cunningham F G, Leveno K J, Bloom S L, Dashe J S, Hoffman B L, Casey B M, Spong C Y editors, 2018, Williams Obstetrics ,25th edition, McGraw-Hill, New York, p. 720
Padmaja A and Sravanthi VL. A study of oral nifedipine and intravenous labetalol in severe hypertension in pregnancy at teaching hospital. IAIM 2017;4(8):12-19
Singh D, Singh S, Singh S, Rani R, Verma U, Nigam AK et al. Comparative Evaluation of Efficacy & Safety of Intravenous Labetalol and Oral Nifedipine in Severe Hypertension of Pregnancy. JMSCR 2017;5(3):18941-947.
Shekhar S, Sharma C, Thakur S, Verma S. Oral nifedipine or intravenous labetalol for hypertensive emergency in pregnancy: a randomized controlled trial. Obstetrics & Gynecology. 2013;122(5):1057-63.
Duckitt K, Harrington D. Risk factors for preeclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005 March 12; 330 (7491):565
Dh ali B , Bh att a ch a r ya S , G an guly RP, Bandyopadhyay S, Mondal M, Dutta M. A randomized trial of intravenous labetalol & oral nifedipine in severe pregnancy induced hype rten sion . Inte rnational Jou rnal of Reproduction, Contraception, Obstetrics and Gynecology. 2016;1(1): 42-6.
Gavit Y, Sharma D, Dixit PV. A comparative study of oral nifedipine and intravenous labetalol in control of acute hypertension in severe preeclampsia and eclampsia. International Journal of Reproduction, Contraception, Obstetrics and Gynecology. 2018 February; 7 (2): 719-24 17.
Das S, Biswas S, Das P, Mahapatra B. Comparative study of intravenous labetalol and oral nifedipine for control of blood pressure in severe preeclampsia. IOSR Journal of Dental and Medical Sciences 2015;14(10):22-27.
Devi SR, Devi RKP, Kumar LA, Devi R, Das S, Deepthambika and Abhipsa. Comparative study between oral nifedipine and intravenous labetalol in management of severe pregnancy induced hypertension. European Journal of Pharmaceutical and Research. 2017; 4(9): 291-6.
