A COMPARATIVE STUDY OF INTRAVENOUS LABETALOL AND ORAL NIFEDIPINE FOR CONTROL OF BLOOD PRESSURE IN SEVERE PRE-ECLAMPSIA IN A TERTIARY CARE HOSPITAL

Abstract

Background: Hypertension is the most common medical disorder in pregnancy, complicating 6- 10% pregnancies1. Treatment of severely increased blood pressure is widely recommended to reduce the risk of maternal and fetal complications. Regimens for acute treatment of severe hypertension in pre-eclampsia include intravenous medications. Although effective, these drugs require venous access and careful fetal monitoring and might not be feasible in busy or low resource environments. Therefore, this study aimed to compare the efficacy of intravenous labetalol and oral nifedipine for control of hypertension in severe pre-eclampsia. Objective: To compare efficacy of intravenous labetelol and oral nifedipine when used rapidly to lower high blood pressure in severe pre-eclampsia mothers. Methodology: This is a hospital based prospective randomized interventional comparative trial conducted at Midnapore Medical College and Hospital from April ’21 to Sep ’22. The study has a sample size of 100 patients divided into two groups randomly, group A received intravenous labetelol injection (in escalating dose of 20,40, 80 and 80 mg every 30 mins, maximum dose of 220mg) and group B received oral nifedipine (10mg tablet orally upto 5 doses) every 30 mins2. Target BP is ≤ 150/ 90 mm of Hg. After target BP is reached further antihypertensive given as per choice. Results: In labetalol group 18 (32%) patients achieved target blood pressure with 1 dose, 10 patients (20%) with 2 doses, 14 (28%) with 3 doses and 8 (16%) with 4 doses while in nifedipine group 16 (32%) of patients achieved target blood pressure with 1 dose, 12 patients (24%) with 2 doses, 10 (20%) with 3 doses, 8 (16%) with 4 doses and 4 (8%) with 5 doses and P value is non significant (0.29).The mean average reduction in systolic blood pressure and diastolic blood Pressure after 30 minutes of drug administration was 6.04± 7.38mmHg and 6.88±4.8mmHg for labetalol and for nifedipine it was 4.32±4.22mmHg and 5.12±3.9mmHg with a non significant P value of 0.469. The mean time required to achieve target BP in Group A was 67.2±33.168 minutes and In Group B was 73.2±38.475 minutes with a P value of 0.405 which stands non significant. Conclusion: Oral nifedipine and intravenous labetalol regimens are almost equally effective in acute control of blood pressure in severe preeclampsia.