RESULTS
We randomised 80 pregnant women with hypertensive emergency ( 40 in each group ) to receive oral Nifedipine in group A and iv Labetalol in group B.
In our study, the mean age in nifedipine group was 26.4 ± 4.65 years and in labetalol group was 25.3 ± 5.03 years. Most of the patients were primigravidas with 52.5% and 60% in nifedipine and labetalol group respectively . Also the mean gestational age in Group-A was 33.17 ± 3.9 weeks and in Group-B was 34 ± 3.86 weeks. Thus both the groups did not differ significantly in mean age, gravidity and gestational age.(Table 1)
The Mean Systolic BP in Group-A was 187.2 ± 19.48 mmHg and in Group-B was 183.8 ± 20.96 mmHg (p-value = 0.442) whereas the mean DBP in Group-A and Group-B was 119.5 ± 11.31 mmHg and 114.8 ± 14.85 mmHg respectively p-value = 0.112). There was no significant statistical difference in mean SBP and mean DBP in both the groups (Table 1)
In our study, it was found that Nifedipine required significantly fewer doses and less time to achieve target BP than Labetalol. The mean dose required in nifedipine group to achieve target BP was 2.25 ± 0.74 and in Labetalol group was 2.7 ± 0.91 which was found to be statistically significant (p-value = 0.018). The mean time required to achieve target BP in Nifedipine and Labetalol group was 45.00 ± 14.84 min and 54.00 ± 18.22 min respectively which was also found to be statistically significant (p-value = 0.018). 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 ± 11.49 mmHg as compared to 27.75 ± 15.34 mmHg in labetalol group(p-value = 0.001). This difference in mean decrease in SBP and DBP was found to be statistically significant. Thus decrease in systolic BP and diastolic BP after treatment was more in nifedipine group as compared to labetalol group. (table 2 )
Side effects of drugs on mother and fetus were transient and tolerable and were comparable in both the groups .5% cases in Group-A and 10% cases in Group-B complained of headache. Drowsiness was also seen in 5% and 10% cases in Group-A and Group-B respectively. 5% cases in both groups complained of nausea. Postural hypotension was reported in 2.5% cases in Group-A.(table 3)
Regarding mode of delivery , vaginal and caesarean delivery rates were 35% and 25% in nifedipine group and 40% and 30% in labetalol group and there was no significant difference found between the groups(p-value = 0.642)(table 4).
There was no significant difference found in fetal outcome in both groups. 17.5% and 25% babies in Group-A and Group-B respectively had APGAR score < 7(p value 0.585) The number of NICU admission was 15% in Group-A as compared to 12.5% in Group-B (p value 0.99).The cause of NICU admissions were prematurity and meconium aspiration. There was no perinatal mortality reported in the study.(table 5)