Maternal and fetal haemodynamics in hypertensive pregnancies during maternal treatment with intravenous hydralazine or labetalol

Harper, Andrew C.; Murnaghan, G. A.

doi:10.1111/j.1471-0528.1991.tb10339.x

Cited by 55 publications

(27 citation statements)

References 25 publications

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“…12 Approximately half (12 of 21 trials) enrolled mixed populations of women with pregnancy hypertension; hypertension was usually severe (16 of 21 trials). In 2 trials, single doses were given, 35,41 and in 3 trials, patients were switched to oral antihypertensives when blood pressure had been stabilized. 33,37,38 Most commonly, hydralazine was compared with standard doses of other antihypertensives: nifedipine (8 trials), labetalol (5 trials), ketanserin (4 trials), urapidil (2 trials), epoprostenol (1 trial), or isradipine (1 trial with 3 publications).…”

Section: Severe Hypertension In Pregnancymentioning

confidence: 99%

Antihypertensive Medications in Management of Gestational Hypertension-Preeclampsia

Dadelszen

Magee²

2005

Clinical Obstetrics and Gynecology

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Section: Severe Hypertension In Pregnancymentioning

confidence: 99%

Antihypertensive Medications in Management of Gestational Hypertension-Preeclampsia

Dadelszen

Magee²

2005

Clinical Obstetrics and Gynecology

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“…These finding of significant fall in BP with labetalol are supported by other studies also. [6][7][8][9][10] Similarly in the methyldopa treated group, the mean SBP, mean DBP, and average MAP at the time of admission was 137.56±4.06 mm Hg; 93.28±4.57 mm Hg; and [10][11][12] On comparing the two drugs, SBP, DBP; and MAP on admission was comparable, but at the time of delivery significant fall in SBP, DBP, and MAP was seen in patients receiving labetalol (p<0.001).…”

Section: Exclusion Criteriamentioning

confidence: 88%

A comparative randomized controlled parallel group study of efficacy and tolerability of labetalol versus methyldopa in the treatment of mild preeclampsia

Singhal

Gupta

2015

Int J Basic Clin Pharmacol

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INTRODUCTIONMaternal mortality represents one of the starkest disparities in health outcomes between developing and developed countries, the rich and the poor. An estimated 358,000 maternal deaths occurred worldwide in 2008 and over 8 million women suffer from illness, infection or injury as a consequence of pregnancy or childbirth. These estimates are likely to be underreported. With 99% of deaths occurring in the developing world it comes as no surprise that the majority of these deaths are preventable and that progress toward Millennium Development Goal 5 "the reduction of maternal mortality by 75% by 2015" is stalling. 1Hypertension is the most common problem encountered during pregnancy. It is estimated that globally 6-8% of pregnancies are complicated by hypertension. It is said that preeclampsia and eclampsia contribute to death of a woman every 3 mins worldwide.2 The incidence of preeclampsia is 7 times higher in developing countries (2.8% of live births) as compare to the developed countries (0.4%) Moreover, it is thought that preeclampsia and eclampsia are also associated with one-quarter of stillbirths and neonatal deaths in developing nations. 1,3,4 Mild hypertension, which is defined as systolic blood pressure (SBP) of 140-159 mm Hg or diastolic BP (DBP) of 90-109 mm Hg or both, is common during pregnancy.Even though a recent systematic review found that there was not enough evidence to show the benefit of antihypertensive drugs for mild hypertension during pregnancy, the risk of developing severe hypertension is reduced to half by using antihypertensive medications, 5 so more research is needed. Methyldopa, labetalol and long-acting nifedipine are acceptable oral antihypertensive agents if drug therapy is required in pregnant women with mild to moderate hypertension. ABSTRACT Background:The objective of the current study was to compare the efficacy and tolerability of labetalol versus methyldopa in the treatment of mild preeclampsia. Methods: We carried out a prospective randomized controlled parallel group study on 100 outpatients of Obstetrics and Gynaecology Department of Government Medical College, Patiala, a tertiary care teaching hospital. Pregnant patients (20-40 weeks gestational age) newly diagnosed with blood pressure (BP) of ≥140/90 mm Hg were included in the study. All patients with systolic BP (SBP) ≥160 mm Hg and diastolic BP (DBP) ≥110 mm Hg after 20 weeks of gestation, history of hypertension, renal diseases, diabetes mellitus, epilepsy, and thyroid diseases were excluded from the study. After taking the informed consent, 50 patients each were randomized to either of the two treatment arm-oral labetalol or oral methyldopa. Difference in the BP measurements at the time of admission and at the time of delivery were analyzed by applying paired t-test. For intergroup analysis, we applied independent t-test using SPSS version 16. A p<0.05 was regarded as significant. Results: Both methyldopa and labetalol cause significant fall in SBP, DBP and mean arterial pressure (MAP) in their group...

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“…Antihypertensive agents such as nicardipine [33], niphedipine [34], and methyldopa [35] have reported no significant effects on umbilical arterial flow. However, hydralazine was reported to decrease umbilical arterial pulsatility indices [28,36].…”

Section: Umbilical Arterial Blood Flowmentioning

confidence: 98%

Accurate diagnosis of umbilical circulation

Nakai

Tachibana

Yamamasu

2006

The Ultrasound Review of Obstetrics & Gynecology

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Umbilical arterial flow velocity has been widely used for the estimation of fetal status. This is clinically useful, but affected by physiological characteristics or other factors such as maternal drug administration. Otherwise, umbilical venous pulsation is also used for fetal estimation. But, this particular pattern appeared not only from fetal cardiac problems, but from umbilical cord characteristics. We summarized the various factors which affect the umbilical circulation.

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Maternal and fetal haemodynamics in hypertensive pregnancies during maternal treatment with intravenous hydralazine or labetalol

Cited by 55 publications

References 25 publications

Antihypertensive Medications in Management of Gestational Hypertension-Preeclampsia

Antihypertensive Medications in Management of Gestational Hypertension-Preeclampsia

A comparative randomized controlled parallel group study of efficacy and tolerability of labetalol versus methyldopa in the treatment of mild preeclampsia

Accurate diagnosis of umbilical circulation

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