Evaluation of the Effectiveness of Intravenous Labetalol and Oral Nifedipine for Managing Severe Hypertension during Pregnancy
- 1. Senior Resident, Department of Obs & Gynae, NMCH, Patna
- 2. Professor & HOD, Department of Obs & Gynae, NMCH, Patna
Description
Background and Objectives: Hypertension is the most frequently encountered medical disorder in obstetric practice & remain a major cause of maternal, fetal & neonatal morbidity & mortality. The present study was undertaken to compare the time taken to reach the therapeutic goal of blood pressure after using intravenous labetolol & oral nifedipine in severe hypertension during pregnancy, To compare the efficacy and safety of the IV labetolol and oral nifedipine. Materials and Methods: Sixty women with hypertensive crisis were randomized to receive either oral nifedipine 10 mg or intravenous labetolol 20 mg in equal numbers. Oral nifedipine was given 10 mg stat followed by 10 mg every 30 minutes up to a maximum of 50 mg. Intravenous labetolol was given 20 mg stat followed by 40 mg 10 minutes later then two more doses of 80 mg every 10 minutes up to a maximum of 220 mg. The primary outcome was the number of doses required to achieve target blood pressure (BP) and time required to reduce the mean arterial pressure by 25%. Secondary outcomes analysed included additional drugs required. Conclusion: Oral nifedipine & intravenous labetolol regimens are equally effective in the management of severe hypertension in pregnancy; Nifedipine needs fewer doses to reach target BP and cost effective with the advantage of oral administration. Whereas labetolol needs less time to us reach target BP and appropriate drug in patients with eclampsia.
Abstract (English)
Background and Objectives: Hypertension is the most frequently encountered medical disorder in obstetric practice & remain a major cause of maternal, fetal & neonatal morbidity & mortality. The present study was undertaken to compare the time taken to reach the therapeutic goal of blood pressure after using intravenous labetolol & oral nifedipine in severe hypertension during pregnancy, To compare the efficacy and safety of the IV labetolol and oral nifedipine. Materials and Methods: Sixty women with hypertensive crisis were randomized to receive either oral nifedipine 10 mg or intravenous labetolol 20 mg in equal numbers. Oral nifedipine was given 10 mg stat followed by 10 mg every 30 minutes up to a maximum of 50 mg. Intravenous labetolol was given 20 mg stat followed by 40 mg 10 minutes later then two more doses of 80 mg every 10 minutes up to a maximum of 220 mg. The primary outcome was the number of doses required to achieve target blood pressure (BP) and time required to reduce the mean arterial pressure by 25%. Secondary outcomes analysed included additional drugs required. Conclusion: Oral nifedipine & intravenous labetolol regimens are equally effective in the management of severe hypertension in pregnancy; Nifedipine needs fewer doses to reach target BP and cost effective with the advantage of oral administration. Whereas labetolol needs less time to us reach target BP and appropriate drug in patients with eclampsia.
Files
IJPCR,Vol16,Issue5,Article239.pdf
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Additional details
Dates
- Accepted
-
2024-05-20
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue5,Article239.pdf
- Development Status
- Active
References
- 1. Cunningham FG, Leveno KJ, Bloom SL et al. Hypertensive disorders in pregnancy. Williams Obstetrics 22nd Edn., New York, McGrow-Hill. 2005; 762. 2. Hypertensive disorders in pregnancy 2007. Federation of obstetric and gynecological societies of India (FOGSI) – World population prospects: The 2000 revision, Vol. 1 Comphrensive table, UN, New York, 2001. 3. Report on National High Blood Pressures Education Programme. Working group on high blood pressure in pregnancy. Am J. Obstet. Gynecol 2000; 163: S1-S32. 4. Ion Donald S. Practical obstetric problems. Edi Renu Mishra. P. 280. 5. Update on the use of Antihypertensive drugs in pregnancy. American Heart Association. 2008; 51: 960-969. 6. Khedun S N, J Moodley, T Naicker et al. Drug management of hypertensive disorders of pregnancy. Pharmacol Ther. 1997; 74 (2): 221-258. 7. Goodman and Gill man. Pharmac textbook. 8. Chesley LC. A Short history of preeclampsia. Obstet. Gynecol. 1974; 43: 500- 602. 9. Duckitt K, Harrington D. Riskfactors for pre-eclampsia at antenatal booking. Systematic review of controlled studies. BMJ. 2005;33 0 :565-577. Studd 17thEdi. 10. Sharma JB, Gulati N, Malik S. Maternal and perinatal complications in neurofibromatosis during pregnancy. Int. J. Gynecol. Obstet 1991; 34: 221- 225. 11. Dikker GA, Sibai BM. Etiology and Pathogenesis of preeclampsia. Am. J. Obstet Gynecol. 1998; 179: 1359-1375. 12. Alfirevic Z, Neilson JP. Doppler ultrasonography in high-risk pregnancies; Systematic review with meta-analysis. Am J. Obstet Gynecol. 1995; 172: 1379. 13. Gonzalez JM, Stamilio DM, Ural S, et al. Relationship between abnormal fetal testing and adverse perinatal outcomes in intrauterine growth restriction. Am. J. Obstet. Gynecol. 20 07; 196: e48. 14. Ott WJ, Mora G, Arias F et al. Comparison of the modified biophysical profile to a 'new" biophysical profile incorporating the middle cerebral artery to umbilical artery velocity flow systolic / diastolic ratio. Am.J. Obstet Gynecol.1998; 178: 1346. 15. Sibai BM. Treatment of hypertension in pregnant women. N. Engl. J. Med. 1996; 335: 257-265.