PS-C30-5: COMPARISON OF INTRAVENOUS LABETALOL WITH ORAL NIFEDIPINE FOR CONTROL OF BLOOD PRESSURE IN SEVERE PREECLAMPSIA

Abstract

Objective: The objective was to compare the effect of intravenous labetalol and oral nifedipine in severe preeclampsia in terms of time interval and the dose required to achieve the targeted blood pressure of 150/100 mm Hg. Design and method: Pregnant women at or beyond 28 weeks POG with live fetus and severe preeclampsia with blood pressure 160/110mmHg or more were enrolled and randomized into two groups. Women in group A received injection labetalol 20 mg and group B received 10 mg oral nifedipine. Blood pressure was monitored at an interval of 20 minutes. Intravenous labetalol for group A participants was repeated at 20 minutes interval in escalating doses of 40,80,80 and 80 upto maximum of 5 doses adding upto 300 mg until the target blood pressure was reached. In group B participants received oral nifedipine 10 mg orally at 20 minutes interval upto maximum of 5 doses adding upto 50 mg. If blood pressure was still not controlled then crossover of treatment was planned in the same manner after 2 hours of starting initial treatment such that participants receiving group A drug would receive group B and vice versa. Results: Total of 104 participants with 52 in each group were enrolled. The mean age of the participants was 24.01 ± 0.7 years. Primigravida were 82(78.8%) and 22(21.2%) were multigravida. The mean POG at enrollment was 36 to 37 weeks in both the groups (p = 0.9). The mean systolic blood pressure was 175.28 mmHg in the labetalol group and 175.23 in the nifedipine group (p = 0.7). The mean diastolic blood pressure was 119.57mmHg in labetalol group and 117.40 in the nifedipine group (p value = 0.8). Among labetalol group, maximum 76.9% participants achieved target blood pressure in 20 minutes after the first dose whereas 36.5% participants took 60 minutes with three doses to achieve target blood pressure in nifedipine group which was statistically significant (p = 0.00). Forty two (80.7%) had vaginal delivery and 10 (19.2%) participants had cesarean section in labetalol group. In nifedipine group 40(76.9%) participants had vaginal delivery and 12(23.1%) had cesarean section (p = 0.8). In both the groups Apgar score of newborn was normal for 82.7% of participants. Conclusion: Intravenous labetalol is more efficacious than oral nifedipine in terms of less time and low dose required to control blood pressure in severe preeclampsia.