Comparative Study of Efficacy and Safety of Oral Nifedipine and Intravenous Labetalol for Hypertensive Emergencies in Pregnancy
Authors/Creators
- 1. Senior Resident, Dept. of Obs. and Gynae, JLN Medical College, Bhagalpur
- 2. Associate Professor and Head of Department, Dept. of Obs. and Gynae, JLN Medical College, Bhagalpur
Description
Background: Hypertensive emergency in pregnancy is defined as per sistent acute-onset, severe hypertension (Systolic BP>160 mmHg or diastolic BP >110 mmHg or both) in the setting of preeclampsia or eclampsia. Objective: Compare safety and efficacy of oral nifedipine and intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy Study Design: a randomised comparative hospital based study conducted in Department of Obstetrics and Gynaecology, J.L.N Medical College, Bhagalpur from April 2020 to December 2020 in 80 women with hypertensive emergencies. Method: Divided into 2 groups of 40 each. Nifedipine group received 10mg tab every 20 min till maximum of 5 doses and labetalol group was given iv labetalol in escalating doses of 20, 40, 40, 80and 80mg every 20 min till a target BP was achieved. Results: In our study, mean time required to achieve target BP in nifedipine and labetalol group was 4514.84 and 54+18.22 minutes (p value 0.018) respectively. Mean decrease in SBP after treatment was 59 ± 21.1 mmHg in Nifedipine group as compared to 42.25 ± 22.7 mmHg in Labetalol (p – value = 0.001). Also the mean decrease in DBP in nifedipine group was 37.5 ± 11.49mmHg as compared to 27.75 ± 15.34 mmHg in labetalol group (p – value = 0.001). There were no significant differences between side effects and fetomaternal outcome. Conclusion: Oral Nifedipine controls hypertension more rapidly and with fewer doses and is as safe as iv Labetalol.
Abstract (English)
Background: Hypertensive emergency in pregnancy is defined as per sistent acute-onset, severe hypertension (Systolic BP>160 mmHg or diastolic BP >110 mmHg or both) in the setting of preeclampsia or eclampsia. Objective: Compare safety and efficacy of oral nifedipine and intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy Study Design: a randomised comparative hospital based study conducted in Department of Obstetrics and Gynaecology, J.L.N Medical College, Bhagalpur from April 2020 to December 2020 in 80 women with hypertensive emergencies. Method: Divided into 2 groups of 40 each. Nifedipine group received 10mg tab every 20 min till maximum of 5 doses and labetalol group was given iv labetalol in escalating doses of 20, 40, 40, 80and 80mg every 20 min till a target BP was achieved. Results: In our study, mean time required to achieve target BP in nifedipine and labetalol group was 4514.84 and 54+18.22 minutes (p value 0.018) respectively. Mean decrease in SBP after treatment was 59 ± 21.1 mmHg in Nifedipine group as compared to 42.25 ± 22.7 mmHg in Labetalol (p – value = 0.001). Also the mean decrease in DBP in nifedipine group was 37.5 ± 11.49mmHg as compared to 27.75 ± 15.34 mmHg in labetalol group (p – value = 0.001). There were no significant differences between side effects and fetomaternal outcome. Conclusion: Oral Nifedipine controls hypertension more rapidly and with fewer doses and is as safe as iv Labetalol.
Files
IJPCR,Vol16,Issue7,Article198.pdf
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Additional details
Dates
- Accepted
-
2024-06-25
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/16/IJPCR,Vol16,Issue7,Article198.pdf
- Development Status
- Active
References
- 1. Cunningham FG, Leveno KJ, Bloom SL, et al. Hypertensive disorders of pregnancy. Chapterin Cunningham, F Gary. III. Williams, Jeds, Williams Obstetrics, 25 the dition; 34:70670 9. 2. American College of O, Gynecologists, Task Force on Hypertension in P. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. 3. Committee on Obstetric Practice. Committee Opinionno.514: emergent therapy foracuteonset,severe hypertension with preeclampsia or eclampsia. Obstet Gynecol.2011;118: 146 5–8. 4. National Institute of Health and Clinical Excellence. Hypertension in Pregnancy. The management of hypertensive disorders during pregnancy. Clinical guidelines CG107 Issued: 2010. 5. Mac Carthy EP, Bloomfield SS. Labetalol: a review of its pharmacology, pharmacokinetics, clinical uses and adverse effects. Pharmacotherapy.1983;3 (4):193–219. 6. Kumari VR, Saraswathi K, Srilaxmi A. Oral nifedipine versus intravenous labetalol for control of blood pressure in severe preecl ampsia. J. Evolution Med DentSci.2016;5 (20): 994-997,d oi:10.14260/jemds/2016/231 7. Shekhar S, Sharma C, Thakur S,Verma S.Oral Nifedipine or Intravenous Labetalol for hypertensive emergency in pregnancy: a randomized controlled trial. Obstet Gynecol.2013; 122(5):1057-63. 8. Prof. S. Randhoni Devi, Dr. R.K. Praneswori Devi, Dr. L. Ajit Kumar, Dr. Romita Devi, Dr. Sujit Das, Dr. Deepthambika and Dr. Abhipsa. Comparative Study between Oral Nifedipine and Intravenous Labetalol in Management of Severe Pregnancy Induced Hypertension. European Journal of Pharmaceutical and Medical Research.2017; 4(9): 291 -296. 9. Gavit Y, Sharma D, Dixit PV. A comparative study of oral nifedipine and intravenous labetalol in control of acute hypertension in severe pre-eclampsia and eclampsia. International Journal of Reproduction, Contracep-tion, Obstetrics and Gynecology. 2018 Feb; 7(2):719-724. 10. Dhali B, Bhattacharya S, Ganguly R, Bandyopadhyay S, Mondal M, Dutta M. A randomized trial of intravenous labetalol and oral nifedipine in severe pregnancy-induced hypertension. Int J Reprod Contra cept Obstet Gynecol.2012;1: 42.