A comparative study of oral nifedipine and intravenous labetalol in control of acute hypertension in severe pre-eclampsia and eclampsia

Gavit, Yogita; Sharma, Deepika; Dixit, Pratibha

doi:10.18203/2320-1770.ijrcog20180201

Cited by 5 publications

(10 citation statements)

References 13 publications

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“…17 Vermillion et al, and Gavit Y et al, in their studies reported 100% success rate to achieve the target blood pressure with both drugs. 12,18 In the present study, it is evident that volume of urine output, in patients treated with oral nifedipine was significantly higher at the end of the first hour of treatment in comparison to intravenous labetalol; significantly increased urine output in nifedipine group persisted at least till 24 hours after the commencement of the treatment. Barton J et al, and Dhali B et al in their studies reported similar significant increase in urine output in nifedipine group.…”

Section: Resultssupporting

confidence: 45%

“…Intergroup difference of adverse effects was not statistically significant. [16][17][18] Oral nifedipine group also required less number of doses to achieve the target BP in comparison to IV labetalol (1.75±0.840 vs. 2.18±0.83), p= 0.024. However, both the drugs were successful in achieving the target blood pressure within the study period and so no patients required crossover treatment.…”

Section: Resultsmentioning

confidence: 99%

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Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomized controlled trial

Alam

Zakaria

2019

Int J Reprod Contracept Obstet Gynecol

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Background: To compare intravenous labetalol with oral nifedipine in terms of rapidity at which they control blood pressure in acute hypertensive emergencies of pregnancy.Methods: A randomized controlled study. Pregnant women with severe gestational hypertension with BP ≥160/110 mmHg after ≥20 weeks of gestation were randomized with computer generated numbers, either to receive IV labetalol with an escalating dose of 20, 40, 80, 80 and 80 mg or nifedipine capsule orally in a dose of 10 mg every 15 minutes (upto 5 doses) until a BP of ≤150/100 mmHg is achieved. Crossover treatment was to be effected if initial treatment regimen was unsuccessful. Primary outcome was time taken and number of doses required to achieve the target BP of ≤150/100 mmHg. Secondary outcomes were volume of urine output, maternal heart rate changes, fetal heart rate abnormality, perinatal and maternal outcome and side effects.Results: Oral nifedipine achieved the target BP (≤150/100 mmHg) more rapidly in (26.25±12.60) minutes in comparison to (32.62±12.19) minutes with IV labetalol (p= 0.024). Nifedipine group also took less number of doses to achieve the target BP of (≤150/100 mmHg) mmHg than IV labetalol (1.75±0.840 vs. 2.18±0.83), p= 0.024. Volume of urine output was also significantly more in nifedipine group (94.90±1.84 ml) at 1 hour and thereafter till 24 hour of treatment in comparison to IV labetalol (41.28±2.14 ml), p= 0.000. Side effects are few and not serious. No patient required crossover treatment.Conclusions: Both the drugs are equally effective in controlling acute hypertensive emergencies of pregnancy, however oral nifedipine is more rapid in controlling severe hypertension and also it is associated with significantly increased urine output.

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Section: Resultssupporting

confidence: 45%

Section: Resultsmentioning

confidence: 99%

Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomized controlled trial

Alam

Zakaria

2019

Int J Reprod Contracept Obstet Gynecol

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“…Similar trials conducted by Raheem et al, Shekhar et al, Anjuman et al and Yogita et al showed that BP control was controlled significantly earlier in patients who were given Nifedipine as compared to labetalol and they required less number of doses. 7 , 10 - 12 Lakhshami et al declared labetalol superior regarding earlier control of BP while Shi DD et al reported both achieved BP control at same time with two doses in both groups. 13 , 14 The difference results in various trials may be related to the smaller number of participants in each group.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, average gestation was 34.8±2.73 weeks in labetalol Group-And 35.2±2.48 weeks in patients given Nifidepine with average birth weight of 2.2±0.41kg and 2.3±0.38 kg respectively (p>0.05) This is in contrast to studies reported by Raheem et al and Yogita et al where majority babies delivered at gestational age of 37-39 weeks. 5 , 12 The reason may be that quite a lot of our patients were unbooked and were not taking any antenatal care. Regular antenatal care has key role to play in BP control and hence prolongation of pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Oral Nifidepine versus IV labetalol in severe preeclampsia: A randomized control trial

et al. 2020

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Objective: To compare oral Nifidepine and IV labetalol in terms of rapidity of BP control in severe preeclampsia. Methods: All patients coming to Services Hospital from March 2017 to February 2019 with diagnosis of severe preeclampsia ≥ 24 weeks gestation were randomized to either receive Nifidepine or Labetalol. Primary outcome measure was time taken to control BP and number of doses required. Secondary outcome measures were side effects of drugs, APGAR score, NICU admission and perinatal mortality. Results: Two hundred four patients were included in trial with 102 patients in each group. Labetalol took 22.6± 13.5minutes and Nifidepine took 22.09± 11.7 minutes to achieve target BP (p>0.05). Labetalol required 2.3± 1.58 doses and Nifidepine 2.2± 1.58 doses to control BP ( p>0.05). No maternal side effects were seen in 86 (84.31%) and 92(90.19%) patients in both groups (p>0.05). Mean gestational age at birth was 34.8 ±2.73weeks in Labetalol and 35.2±2.48 weeks in Nifidepine group (p>0.05). In labetalol group, 43 (42.15%) babies had APGAR Score < 7/10 and 23(22.54%) babies required admission to NICU while in Nifidepine group 42 (41.17%) babies had Apgar score < 7/10 & 30(29.4%) babies were admitted to NICU(p>0.05). There were 21(20.5%) perinatal deaths in labetalol Group-And 19(18.6%) in Nifidepine group (p>0.05) Conclusion: Oral Nifidepine and IV labetalol are equally efficacious in controlling BP in patients with severe pre eclampsia without any significant side effects. doi: https://doi.org/10.12669/pjms.36.6.2591 How to cite this:Wasim T, Agha S, Saeed K, Riaz A. Oral Nifidepine versus IV labetalol in severe preeclampsia: A randomized control trial. Pak J Med Sci. 2020;36(6):---------. doi: https://doi.org/10.12669/pjms.36.6.2591 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Gestational age in group I patients was 36-37 weeks seen 4 in group I and 5 in group II, 37-38 weeks seen 10 in group I and 9 in group II, 38-39 weeks 11 in group I and 10 in group II and >39 weeks 5 in group I and 6 in group II. Gavit et al, [8] compared oral Nifedipine and intravenous Labetalol in control of acute hypertension in severe preeclampsia and eclampsia. In this study, 40 sample size treated with intravenous Labetalol and other 40 sample size treated with oral Nifedipine.…”

Section: Discussionmentioning

confidence: 99%

Oral Labetalol Verses Oral Nifedipinein Hypertensive Disorders of Pregnancy- A Comparative Study

Bhushan¹,

Singhal²

2019

AJMR

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Background: Hypertensive disorders of pregnancy are the common medical disorders in pregnancy. The present study was conducted to compare oral labetalol and oral nifedipine in hypertensive disorders of pregnancy. Subjects and Methods: The present study was conducted on 60 pregnant women. Preterm or term pregnant women with severe preeclampsia/ eclampsia and BP ≥160/100 mm Hg were included in the study. Patients were divided into 2 groups of 30 each. Group I patients were given oral labetalol and group II were given oral 10 mg Nifedipine. Results: Primi was seen in 18 in group I and 17 in group II, G2 6 in group I and 5 in group II, G3 4 in group I and 5 in group II and G4 2 in group and 3 in group II. The difference was non-significant (P> 0.05). In group I, SBP was 174.2 mm Hg in group I and 166.4 mm Hg in group II, DBP was 112.6 mmHg in group I and 110.8 mm Hg in group II. The difference was significant (P< 0.05). Conclusion: The study concluded that oral Nifedipine better in terms of lowering blood pressure in pregnant ladies, although the difference was nonsignificant.

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A comparative study of oral nifedipine and intravenous labetalol in control of acute hypertension in severe pre-eclampsia and eclampsia

Cited by 5 publications

References 13 publications

Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomized controlled trial

Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomized controlled trial

Oral Nifidepine versus IV labetalol in severe preeclampsia: A randomized control trial

Oral Labetalol Verses Oral Nifedipinein Hypertensive Disorders of Pregnancy- A Comparative Study

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