A Comparative Study on Effectiveness of Oral Labetalol Versus Oral Nifedipine Used in the Treatment of Gestational Hypertension in a Tertiary Care Teaching Hospital

Abstract

Background Gestational hypertension is associated with increased risk of adverse maternal and fetal outcomes. Drug treatment is generally reserved for moderate or severe cases of gestational hypertension. Nifedipine and labetalol are the drugs which are exclusively used in oral anti-hypertensives to treat gestational hypertension where both belong to Category-C. Hence a prospective observational study was designed to compare the effectiveness of oral labetalol versus oral nifedipine used in the treatment of gestational hypertension.Aim To compare the efficacy safety availability cost minimization prescribing patterns of oral labetalol and oral nifedipine in the treatment of gestational hypertension.Methodology This is a prospective observational study conducted in Chigateri district hospital Davanagere Tertiary care teaching hospital for a period of six months where data of 150 subjects diagnosed with gestational hypertension were obtained from the department of Obstetrics and Gynecology OBG from the case sheets during ward rounds. Out of this 27 cases are excluded due to insufficient data.Results Among the studied subjects only 59 47.97 were prescribed oral antihypertensive drugs either labetalol or nifedipine. 88.89 subjects treated with nifedipine showed low birth weight LBW and 51.1 subjects had preterm deliveries. Both labetalol and nifedipine were found to have similar efficacy but nifedipine was associated with low birth weight in more cases when given prenatally. Cost of generic medicines was found to be very less when compared to highly prescribed brands.Conclusion Both labetalol and nifedipine retard exhibited similar efficacy but the cost of nifedipine was less when compared to labetalol in highly prescribed brands. In generic drugs the margin of difference between the costs of both the drugs was found to be less. Among the subjects who were prescribed nifedipine prenatally low birth weight neonates and other fetal adverse effects were observed. Therefore labetalol may be prescribed prenatally while nifedipine can be prescribed postnatally considering both efficacy and cost factor.