58-OR

Abstract

Objectives To compare the efficacy of intravenous labetalol or oral nifedipine in treatment of acute maternal hypertension and study the fetal and maternal hemodynamic changes using color Doppler ultrasound that follows treatment Methods Thirty women with severe preeclampsia having acute hypertension (more than or equal to 160/105 mmHg) were randomized in 2 groups to receive intravenous labetalol or oral nifedipine until blood pressure was lowered to less than or equal to 140/90 mmHg. Doppler vascular indices namely pulsatility index, resistance index, S/D ratio of umbilical (UA), middle cerebral artery (MCA), maternal uterine and renal artery were measured baseline at the time of acute severe hypertension and repeated after control of blood pressure, to assess the changes in maternal and fetal hemodynamic status with labetalol or nifedipine. Results Both nifedipine and labetalol were found to be effective when used for rapid control of blood pressure. The median time to achieve target blood pressure was 20 min in labetalol group and 30 min in nifedipine group (p = 0.348). Mean age of women in both groups and mean gestational age was statistically comparable. Although labetalol caused more reduction in maternal heart rate after treatment (p = 0.058) which was insignificant compared to nifedipine which had no effect on maternal heart rate. No change in fetal heart rate before and after treatment was observed in both groups, Doppler vascular indices of UA and MCA showed no significant changes as compared to baseline values in both groups. Maternal uterine and renal artery Doppler showed no significant change following labetalol or nifedipine treatment. Conclusions Labetalol and nifedipine use was not related to any significant changes in fetal Doppler, which is reassuring about the safety of these drugs when treating acute severe hypertension in pregnancy. Choice between these two drugs should be based on cost, availability respective contraindications, and clinician’s experience. Disclosures S. Gainder: None. M. Thakur: None. S.C. Saha: None. M. Prakash: None.