Oral Nifedipine or Intravenous Labetalol for Hypertensive Emergency in Pregnancy

Shekhar, Shashank; Sharma, Charu; Thakur, S.; Verma, Shipra

doi:10.1097/01.aoa.0000455591.12104.93

Cited by 10 publications

(16 citation statements)

References 5 publications

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“…In studies done by Raheem et al, Shekhar et al and Swapan et al the percentage of vaginal delivery and caesarean section in IV Labetalol group was 48% and 52%, 66.6% and 33.3%, 54% and 46% while in oral Nifedipine 36% and 64%, 56.6% and 43.3%, 46% and 54% respectively. [14][15][16] In this study and in Shekhar et al, caesarean section rates were low, which may be due to better management by antihypertensive agents and low dose of Nifedipine required as it has tocolytic effect in large dose. Table 9 shows Hyperbilirubinemia were 5% and 2.5% in the Labetalol group and Nifedipine group respectively.…”

Section: Resultsmentioning

confidence: 81%

“…In following studies conducted the maternal mean age in both the group in Shekhar et al was 25.9 years, Swapan et al was 25.4 years while in Raheem et al was 31.4 years as the distribution of age was from 20 to 40 years, and sample size was less (n=50) ( Table 1). [14][15][16] 14,16 Hence time required to control raised blood pressure is less with oral Nifedipine as compared with IV Labetalol. Table 8 shows mode of delivery of the two groups.…”

Section: Resultsmentioning

confidence: 99%

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

Gavit

Sharma

Dixit

2018

Int J Reprod Contracept Obstet Gynecol

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Background: This study was conducted to compare oral Nifedipine and intravenous Labetalol in control of acute hypertension in severe pre-eclampsia and eclampsia. This study was observational study with 80 sample size in which 40 sample size treated with intravenous Labetalol and other 40 sample size treated with oral Nifedipine. The maternal and perinatal outcome in two groups sample size with oral Nifedipine and intravenous Labetalol compared and found that nevertheless these results do establish oral Nifedipine as an alternative to IV Labetalol in lowering BP in acute severe hypertension. In summary oral Nifedipine may be preferable as it has a convenient dosing pattern orally.Methods: The present study was conducted in tertiary care centre Mumbai from June 2016 to October 2016. All pregnant woman diagnosed with acute hypertension in severe pre-eclampsia and eclampsia in labour room were enrolled in the study.Results: In the present study oral Nifedipine as an alternative to IV Labetalol in lowering BP in acute severe hypertension. In summary oral Nifedipine may be preferable as it has a convenient dosing pattern orally.Conclusions: A hypertensive disorder of pregnancy is one of the life-threatening complication encountered in obstetrics and globally is major cause of maternal morbidity and mortality. Management of acute severe hypertension in pregnancy is a challenging task. Present study compares the efficacy of oral Nifedipine and IV Labetalol in reaching the therapeutic goal. From the results of this study we can well conclude that oral Nifedipine is more efficacious.

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Section: Resultsmentioning

confidence: 81%

Section: Resultsmentioning

confidence: 99%

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

Gavit

Sharma

Dixit

2018

Int J Reprod Contracept Obstet Gynecol

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“…Studies compared hydralazine with the labetolol and nifedipine with the labetolol found all three are equally effective in controlling hypertension. 11,12 But the cost of nifedipine is 1/25 th and 1/40 th times that of labetolol and hydralazine. So nifedipine can be a good alternative in low resource country like India over the other drugs.…”

Section: Discussionmentioning

confidence: 99%

A prospective observational study for the evaluation of maternal and fetal outcome in patient with eclampsia

et al. 2017

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Background: Eclampsia continues to be a measure health issue in developing country. In order to get a comprehensive data on eclamptic patients we conduct a prospective observational study to address the maternal and fetal complication during pregnancy.Methods: It is a prospective observational study conducted in a tertiary care medical college between the periods September 2016 to February 2017. During the period all patients with eclampsia admitted to the labour room were taken. Any patients with known epilepsy were excluded from the study.Results: During the period 3780 women were admitted to the labour room, out of which 56 women had eclampsia with an incidence of 1.48%. Out this antenatal eclampsia was most common with an incidence of 91.08% followed by intra partum 4 (7.14%) and postpartum eclampsia 1 (1.78%). Majority of patients 54 (96.43%) were unbooked or inadequately supervised. Most of the patient had normalization of blood pressure after oral nifedipine 46 (82.14%), only 10 (17.86%) patient required additional injection labetalol for control of blood pressure. The maternal complications were placental abruption 8 (14.28%), HELLP 6 (10.71%), pulmonary edema 1 (1.78%), acute renal failure 1 (1.78%), DIC 1 (1.78%) and maternal death 2 (3.57%). Out of fifty six babies delivered 42 (75%) had live birth and 14 (25%) had still birth. A total of 17 (40.42%) had IUGR, 17 (40.47%) require SNCU admission post-delivery.Conclusions:Eclampsia still remains the major cause of maternal and fetal morbidity. In low resource countries improvement in health care facility, adequate antenatal supervision, and timely referral will reduce the maternal and fetal complication.

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“…El nifedipino, un vasodilatador periférico antagonista de los canales lentos de calcio; recomendado en pacientes con sobrecarga de volumen, por aumento de la perfusión renal y en la diuresis, de acción rápida e indicado en el manejo de crisis hipertensivas y de mantenimiento, puede producir taquicardia, cefalea y enrojecimiento facial, su combinación con sulfato de magnesio debe estar vigilado por el riesgo de bloqueo neuromuscular (17)(18)(19)(20). Con respecto al uso en la lactancia materna se considera de riesgo muy bajo (nivel 0), se excreta en cantidades no significativas, no se ha observado alteraciones en los lactantes, ni tampoco altera la composición de la leche materna (16), de la misma manera la academia americana de pediatría lo toma como un medicamento compatible con la lactancia (21).…”

Section: Calcioantagonistasunclassified

Hipertensión/preeclampsia postparto, Recomendaciones de manejo según escenarios clínicos, seguridad en la lactancia materna, una revisión de la literatura

Martínez

Rendón

Gallego

et al. 2017

Rev. chil. obstet. ginecol.

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Articulo de RevisiónHipertensión/ preeclampsia postparto, Recomendaciones de manejo según escenarios clínicos, seguridad en la lactancia materna, una revisión de la literatura. RESUMENObjetivo: Establecer recomendaciones en el tipo de antihipertensivo que se debe seleccionar según escenarios clínicos en la hipertensión/preeclampsia postparto, dosis y pautas de seguridad en lactancia. Métodos: Se realizó una búsqueda bibliográfica en inglés y español, utilizando las bases de datos PubMed, Ebsco y Science Direct, tomando como palabras clave los descriptores del Decs (español) y Mesh (inglés), realizando combinaciones con la conjunción Y (AND) y la disyunción O (OR), que hubieran evaluado el manejo, seguimiento en hipertensión y preeclampsia posparto. Como criterio de inclusión se tomaron estudios tipo Revisiones sistemáticas, ensayos clínicos, guías de práctica clínica, estudios observacionales, la calidad de los artículos se evaluó por PRISMA, CONSORT y STROBE según corresponda y se utilizó la herramienta Cochrane para la evaluación del riesgo de sesgos.Resultados: Se identificaron 59 artículos que cumplieron con los requisitos preestablecidos, se encontró que el reconocimiento de la hipertensión posparto es de vital importancia por el riesgo de complicaciones maternas, existe un grupo de mayor riesgo: las que presentaron trastorno hipertensivo ante parto sobre todo severo y con parto pretérmino, de ahí la importancia de vigilar la presión arterial en este periodo. La crisis hipertensiva requiere pronto reconocimiento, evaluación y tratamiento estandarizado para prevenir daño en órgano blanco. Los antihipertensivos de primera línea a utilizar durante la crisis son: labetalol, nifedipino, hidralazina, no existiendo diferencias estadísticas entre ellos con respecto al alcance de metas de control de presión arterial, ni en el tiempo de alcance de estas, tampoco diferencias en resultados adversos maternos perinatales, en la hipertensión no crisis el medicamento a elegir depende de la experticia sobre el fármaco que el clínico tenga, no hay un fármaco superior a otro, y finalmente se encontró que la mayoría de los antihipertensivos utilizados son de amplia seguridad en la lactancia materna, se consideran seguros de riesgo muy bajo (nivel 0) y riesgo bajo (nivel 1).REV CHIL OBSTET GINECOL 2017; 82(2) 220 Conclusiones: Los antihipertensivos de primera línea a utilizar durante la crisis son: labetalol, nifedipino, hidralazina, en la hipertensión no crisis el medicamento a elegir depende de la experticia sobre el fármaco que el clínico tenga, no hay un fármaco superior a otro, y en lactancia materna la mayoría de los antihipertensivos son considerados de amplio margen de seguridad.Palabras clave: posparto, preeclampsia, hipertensión, antihipertensivos, lactancia materna. ABSTRACTObjective: To establish recommendations on the type of antihypertensive that should be selected according to clinical scenarios in postpartum hypertension / preeclampsia, doses and safety guidelines in lactation. Methods: A bibliographic search w...

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Oral Nifedipine or Intravenous Labetalol for Hypertensive Emergency in Pregnancy

Cited by 10 publications

References 5 publications

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

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

A prospective observational study for the evaluation of maternal and fetal outcome in patient with eclampsia

Hipertensión/preeclampsia postparto, Recomendaciones de manejo según escenarios clínicos, seguridad en la lactancia materna, una revisión de la literatura

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