Comparative study of oral nifedipine versus intravenous labetalol in severe hypertension in pregnancy: A randomized controlled study

Authors : Rekha Sahai, Anupam Nidhi, Rita Ranjan, Shyam Lal

DOI : 10.18231/j.ijogr.2020.016

Volume : 7

Issue : 1

Year : 2020

Page No : 75-80

Objective: To compare the efficacy of oral nifedipine with intravenous labetalol in the treatment of severe
hypertension in pregnancy.
Materials and Methods: It was a double-blind, randomized, controlled study conducted in pregnant
women with blood pressure 160/110 mm Hg. Total 60 patients were enrolled from October 2016 to
September 2017. Patients were randomized to receive nifedipine (10 mg tablet orally up to five doses) and
intravenous placebo saline injection or intravenous labetalol injection in doses of 20, 40, 80, 80, and 80 mg
and a placebo tablet every 20 minutes until the target blood pressure of 150/100 mmHg was achieved.
The primary outcome of the study was time necessary to achieve target blood pressure. Secondary outcome
were number of doses required, onset of labour, mode of delivery, adverse maternal and neonatal effects,
side effect, and perinatal outcome.
Results: The time to achieve the blood pressure goal was significantly shorter with nifedipine (mean SD,
34.67 20.297 minutes) than with labetalol (52.00 29.054minutes; P <.017). Nifedipine group required
significantly lower doses (mean SD, 1.731.015) as compared to labetalol (2.601.453, p<0> Urine output was significantly increased in nifedipine group (mean SD, 2296 210.483 ml) compared
with labetalol group (1374 155.798 ml, P < .0001) and remained significantly increased 24 hours after
initial administration. No patients required crossover therapy. The a dverse effects were infrequent. There
were no significant differences in maternal age, gestational age, and blood pressures between the groups.
Conclusion: Oral nifedipine and intravenous labetalol both are effective in the management of severe
hypertension of pregnancy; however, nifedipine controls hypertension more rapidly with less number of
dos es and was associated with a significant increase in urinary output.

Keywords: Pregnancy Induced Hypertension, Nifedipine, Labetalol, Pre-eclampsia,Pregnancy


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