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.