Abstract:
Background - Hypertensive emergency in pregnancy is defined as
persistent acute-onset, severe hypertension (Systolic BP
>160 mmHg or diastolic BP >110 mmHg or both)
in the setting of preeclampsia or eclampsia. Objective -
Compare safety and efficacy of oral nifedipine and intravenous labetalol
for acute blood pressure control in hypertensive emergencies of
pregnancy Study design – a randomised comparative hospital
based study conducted in Department of Obstetrics and Gynaecology, SMS
Medical College, Jaipur from April 2018 to Nov 2018. Sample -
80 women with hypertensive emergencies Method - Divided into 2
groups of 40 each. Nifedipine grp received 10mg tab every 20 min till
maximum of 5 doses and labetalol grp was given iv labetalol in
escalating doses of 20, 40, 40,80 and 80mg every 20 min till a target BP
was achieved. Main outcome measures – Better treatment for
Hypertensive emergencies of pregnancy Results – In our study,
mean time required to achieve target BP in nifedipine and labetalol
group was 45+14.84 and 54+18.22 minutes (p value 0.018) respectively.
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).
There were no significant differences between side effects and
fetomaternal outcome. Conclusion - Oral Nifedipine controls
hypertension more rapidly and with fewer doses and is as safe as iv
Labetalol.
Keywords : nifedipine,labetalol, hypertensive emergency