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A randomized trial of intravenous labetalol & oral nifedipine in severe pregnancy induced hypertension

Badal Dhali, Shritanu Bhattacharya, Rajendra Prasad Ganguly, Shrirupa Bandyopadhyay, Mousumi Mondal, Mousumi Dutta.

Abstract
Background: Hypertension is the most frequently encountered medical disorder in obstetrics practice & remain a major cause of maternal, fetal & neonatal morbidity & mortality. The present study was undertaken to compare the time taken to reach the therapeutic goal blood pressure after using intravenous labetalol & oral nifedipine in severe pregnancy induced hypertension.
Methods: Randomly allocated patients received labetalol 20 mg initially, followed by escalating doses of 40, 80, 80 & 80 mg & a placebo tablet every 20 minutes or initially nifedipine tablet 10 mg orally with repeated doses of 20 mg every 20 minutes up to 5 doses & intravenous placebo 0.9% isotonic saline until the therapeutic goal blood pressure, Systolic ≤ 150 mmHg & diastolic ≤ 100 mmHg was achieved. Primary and secondary outcomes like the time interval required to achieve a blood pressure of ≤150/100 mmHg and urinary output, agent failure & adverse effects respectively were reported.
Results: Patients received oral nifedipine achieved the goal therapeutic blood pressure more rapidly in 28.211.7 minutes (meanSD) as compared with 48.423.5 minutes in those received intravenous labetalol (p=0.001). The nifedipine group also required significantly fewer doses (3.50.5 vs 4.51.5; p=0.001) to reach the goal blood pressure. Urine output was significantly increased (p

Key words: Severe pregnancy induced hypertension, Nifedipine, Labetalol


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