A randomized trial of intravenous labetalol versus oral nifedipine in acute blood pressure control in hypertensive emergencies of pregnancy

Abstract

Hypertension (HTN) is a worldwide health problem that affects about 25-40% of individuals. Hypertension in pregnancy is associated with adverse effects for both mother and baby which includes fetal growth restriction, preterm delivery and maternal, fetal, and neonatal morbidity and mortality. These women are at greater risk for the development of cardiovascular risk factors (hypertension, type 2 diabetes, and obesity), chronic kidney disease and premature cardiovascular disease. Severe hypertension in pregnancy is defined by a systolic blood pressure of at least 160 mm Hg or diastolic blood pressure of at least 110 mm Hg. A combined team of obstetricians and cardiologists is an important prerequisite for management of HTN and cardiovascular disease during pregnancy. Labetalol and nifedipine have quickly emerged as alternative drugs for management of gestational hypertension. A Prospective randomized double blind comparative clinical trial was conducted in the Department of Obstetrics & Gynaecology of Darbhanga Medical College & Hospital, Laheriasarai, Bihar which took the study period from April 2019 to December 2020. The present study was executed upon 106 pregnant women with pre-eclampsia with a gestational period of 28 weeks or beyond with blood pressure reading ≥160/110 mmHg. All the patients were randomly divided into two groups Group A and B. Group A patients received intravenous Labetalol and Group B patients received oral Nifedipine as antihypertensive drugs to achieve the target blood pressure reading 150/100.The present study aimed to compare the two most commonly used drugs, oral nifedipine and IV labetalol in terms of time taken to achieve the target blood pressure and number of dosage required.