MATERIAL AND METHODS
The study was conducted in Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur from June 2018 to August 2019. It was a hospital based prospective randomised interventional comparative study conducted on 80 pregnant women with hypertensive emergency fulfilling inclusion criteria and exclusion criteria.
Inclusion criteria- patients with singleton viable pregnancies with persistent systolic BP ≥160 mmHg or diastolic BP ≥110 mmHg or both
Exclusion criteria- any medical disorders like cardiac disease, bronchial asthma, hematological disorder, diabetes mellitus, liver or renal disorders and thyrotoxicosis or any allergy or contraindications to Labetalol or Nifedipine.
After proper counselling regarding the purpose of study, a written and informed consent was taken following which 80 cases were randomly divided in two groups - Group-A (oral Nifedipine) and Group-B (iv labetalol) 40 in each group. Standard Mercury sphygmomanometer of appropriate sized cuff was used to measure BP with the patient in sitting or semi reclining position with back support. All basic investigations and sonography with doppler was done. Oral Nifedipine or iv Labetalol were given as: -
Oral Nifedipine (Group-A) : Patients in this group were given 10 mg oral tablet initially, with repeated doses of 10 mg, every 20 minutes, for up to a maximum of 5 doses, or until the target BP was achieved whichever was earlier.
IV Labetalol (Group-B) : Patients in this group, were given 20 mg intravenous labetalol initially followed by escalating doses of 40 mg, 80 mg, 80 mg, and then 80 mg, every 20 minutes, until the target BP was achieved, or for a maximum of five doses whichever was earlier.
Goal was to achieve a target BP of less than or equal to 150/100 mmHg. Any Side effects of drugs were noted in both the groups. Monitoring of fetal heart rate was done continuously by electronic cardiotocography until BP remained stable (continuous CTG monitoring). In case of non-reassuring maternal or fetal status the trial protocol was abandoned and appropriate measures were taken. Continuation or termination of pregnancy was decided according to gestational age, maternal and fetal condition. The time and dosages taken to control BP in each group.Finally data obtained was statistically analysed with suitable statistical software. The categorical data was presented as numbers (percent) and were compared among groups using chi-square test. Demographic data was presented as standard deviation compared between groups using students ’t’ test. P-value <0.05 was considered statistically significant.