A Randomized Trial of Intravenous Labetalol Versus Oral Nifedipine in Acute Blood Pressure Control in Hypertensive Emergencies of Pregnancy

Abstract

Background: Hypertension in pregnancy, called a disease of degree is more of a sign than a disease by itself. Hypertensive disorders of pregnancy, including chronic hypertension, with or without superimposed pre-eclampsia/eclampsia, gestational hypertension, HELLP syndrome, pre-eclampsia with or without severe features or eclampsia present a significant risk of morbidity to both mother and fetus. Effective pharmacologic therapy modifies the course of the disease. The effective use of anti-hypertensive therapy should be based on well designed controlled clinical trials and the experience of the clinician with the drugs. Hypertensive disorders complicate 5-10% of all pregnancies worldwide. 1 Dangerous hypertension is a harbinger of cerebrovascular accidents, eclampsia, hypertensive encephalopathy and other end organ damage with a poor perinatal outcome. 2 Methods: This prospective randomized double blind comparative clinical trial with randomization done using computer generated numbers study was carried out in 100 cases being brought in OBG department of AL Ameen Medical College, Bijapur, from July 2023 to December 2023. A detailed data of sociodemographic profile, general examination and obstetric examination were carried out. The pregnant women were randomized with computer generated numbers into two groups to receive either oral nifedipine or intermittent intravenous labetalol injections. Results: There is no significant difference in the parity of both the groups. Majority of the patients constituting 80% of group A and 58% of group B were primigravida. 69% enrolled in the study were primigravida. There is a higher incidence of pre-eclampsia in the first pregnancy. The majority of the patients had gestational age of 34 to 36 weeks constituting 48% on the whole with 50% and 46% respectively in group A and B. The recruited patients did not significantly differ in gestational age