Abstract
Objective
To compare the efficacy of intravenous labetalol with oral nifedipine in the treatment
of severe hypertension in pregnancy with blood pressure ≥160/110 mm Hg.
Design, setting and participants
We conducted a parallel double-blinded randomized controlled trial between December
2014 to December 2016 in 120 antenatal women of gestational age >28 weeks, admitted
with severe hypertension of blood pressure ≥160/110 mm Hg to maternity ward at a tertiary
hospital.
The labetalol group received 20 mg initially followed by escalating doses of 40 mg,
80 mg, 80 mg and 80 mg (5 doses) every 15 min to a maximum of 300 mg. Nifedipine group
received 10 mg initially followed by repeated doses of 20 mg every 15 min (total 5
doses) to a maximum of 90 mg. Vital signs were recorded every 15 min.
-The time taken and the number of doses required to achieve the target blood pressure
(150/100 mmHg). Survival analysis was used to compare the efficacy of treatment regimens.
Results
Sixty women were randomised to each group and none were lost to follow-up. None of
the patients in nifedipine group required labetalol, whereas three patients in labetalol
group achieved target BP only after receiving nifedipine was administered after the
maximum dose of labetalol.The mean time taken to achieve the target blood pressure
in the labetalol group was higher (36.75 min) than in the nifedipine group (27.25 min)
[mean difference 9.5 min,p = 0.002]. Nifedipine group required significantly lower
doses (1.82 ± 0.83) as compared to labetalol (2.45 ± 1.32) [p = 0.002]. Nifedipine
was 1.8 times more likely to achieve target blood pressure (Hazard Ratio = 1.8).
Conclusions
Both intravenous Labetalol and oral Nifedipine were effective in controlling blood
pressure. Nifedipine reduced BP more rapidly than Labetalol. Oral Nifedipine may be
a better alternative because of its ease of oral administration and a flat dosing
regimen.
Keywords
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Article info
Publication history
Published online: March 05, 2019
Accepted:
January 20,
2019
Received in revised form:
January 17,
2019
Received:
July 30,
2018
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
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- Erratum to “IV labetalol and oral nifedipine in acute control of severe hypertension in pregnancy–A randomized controlled trial” [Eur. J. Obstet. Gynecol. Reprod. Biol. 236 (May) (2019) 46–52]European Journal of Obstetrics and Gynecology and Reproductive BiologyVol. 247
