Title: Comparative Evaluation of Efficacy & Safety of Intravenous Labetalol and Oral Nifedipine in Severe Hypertension of Pregnancy
Authors: Dr Dibya Singh, Dr Shikha Singh, Prof. Saroj Singh, Dr Rekha Rani, Dr Urvashi Vrema, Dr Ashwini Kumar Nigam, Dr Neeraj Yadav
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.104
Abstract
Objective: Comparative evaluation of efficacy of intravenous labetalol and oral nifedipine in severe hypertention in pregnancy.
Design: Prospective Randamised trial
Setting: S.N. medical college, Agra
Population: Pregnant women with severe hypertension≥160/110 mmHg who required immediate treatment.
Methods: Patients were randomised using random table in to two groups. Group A:40 patients received intravenous labetalol injection(in escalating dose regime 20,40,80,80 and 80 mg).Group B:40 patients received oral Nifedipine (in escalating doses 10, 20,20,20 and 20mg)every 20 minutes until the target blood pressure of ≤160/110 mmHg was achieved or maximum 5 doses used. MAIN OUTCOME MEASURE The time taken to achieve a blood pressure of ≤160/110 mmHg and doses required.
Results: 38(95%)/40 in labelalol group & 40/40 in nifedipine group showed control of adequate control of blood pressure. Difference is not significant(0.331)The median time taken to achieve target blood pressure was 29.5+11.8 and 43.68+16.7 minutes for nifedipine and labetalol, respectively (P=0.00007). Mean systolic and diastolic blood pressure reduction with nifedipine at after first dose was 17.03+7.36 mmhg and 10.75+6.87mmhg respectively. .Mean systolic and diastolic blood pressure reduction with labetalol after first dose was 13.65+5.37 mmhg and 8.6+3.23mmhg respectively. Average no. of doses required with labetalol was significantly more (p=0.00005) than nifedipine. There was no significant difference between both the groups regarding systolic(p=0.465) and diastolic(p=0.08) blood pressure at 24 hours after control of blood pressure.
Conclusions: Both drugs effectively control blood pressure in severe hypertention in pregnancy.
Keywords: Preeaclampsia, Labetalol,Nifedipine.
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