Severe hypertension in pregnancy: Hydralazine or labetalol

Gracia, Paulino Vigil-De; Lasso, Martín; Ruiz, Esteban; Vega-Malek, Juan Carlos; Mena, Flor Tern De; López, Juan Carlos Rivero

doi:10.1016/j.ejogrb.2006.02.015

Cited by 107 publications

(72 citation statements)

References 17 publications

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“…This finding collaborate earlier studies including Cochrane review on the efficacy of either drugs in hypertensive crisis in pregnancy [7][8][9]. In our study group Most of the cases belonged to 21-25 years age group this finding is in contrary with previous studies Ramesh K et al, Lamminpää R et al [10][11].…”

Section: Discussionsupporting

confidence: 83%

A Comparative study of IV Labetalol and IV Hydralazine on mean arterial blood pressure changes in pregnant women with hypertensive emergency

Lila¹,

Lata²,

Prachi³

et al. 2016

SJAMS

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Abstract:The study was undertaken to compare lowering of blood pressure in pregnant women with hypertensive emergency by IV Labetalol and IV Hydralazine and to find out which drug produces better effect. This prospective type of interventional study was conducted in SMS Medical College, Jaipur among 226 women admitted with SBP ≥ 160 or DBP ≥ 110 mmHg or both. Women divided in 2 groups (113 each) devided randomly: Labetalol (Group-A), Hydralazine (Group-B).We measured the difference between pretreatment and after treatment mean arterial blood pressure. Pretreatment mean arterial blood pressure was 127.40±40 and 126.61±6.475 mmHg in labetalol and Hydralazine group respectively. After treatment mean arterial blood pressure was 112.25±5.821 and 109.27±14.30 mmHg in labetalol and Hydralazine group respectively. Mean arterial blood pressure change was 15.14 ± 8.02 mmHg in labetalol group and 17.34 ± 13.42 mmHg in hydralazine group. (p=0.136, Not significant). Labetalol and Hydralazine both drugs are first line drugs in severe hypertension in pregnancy as in our study both drugs control blood pressure in similar way.

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Section: Discussionsupporting

confidence: 83%

A Comparative study of IV Labetalol and IV Hydralazine on mean arterial blood pressure changes in pregnant women with hypertensive emergency

Lila¹,

Lata²,

Prachi³

et al. 2016

SJAMS

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“…142 Another smaller (n=16) trial of hydralazine or labetalol in acute severe PIH revealed the high effectiveness of both drugs, with no effect of either of them on fetal Doppler. 143 In contrast, the group that received hydralazine had a significant increase in uterine arteries resistance.…”

Section: Severe Hypertensionmentioning

confidence: 98%

Pregnancy-Induced hypertension

et al. 2015

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pregnancy-induced hypertension (pIh) complicates 6-10% of pregnancies. It is defined as systolic blood pressure (sbp) >140 mmhg and diastolic blood pressure (dbp) >90 mmhg. It is classified as mild (sbp 140-149 and dbp 90-99 mmhg), moderate (sbp 150-159 and dbp 100-109 mmHg) and severe (SBP ≥160 and DBP ≥110 mmHg). PIH refers to one of four conditions: a) pre-existing hypertension, b) gestational hypertension and preeclampsia (pe), c) pre-existing hypertension plus superimposed gestational hypertension with proteinuria and d) unclassifiable hypertension. pIh is a major cause of maternal, fetal and newborn morbidity and mortality. women with pIh are at a greater risk of abruptio placentae, cerebrovascular events, organ failure and disseminated intravascular coagulation. fetuses of these mothers are at greater risk of intrauterine growth retardation, prematurity and intrauterine death. ambulatory blood pressure monitoring over a period of 24 h seems to have a role in predicting deterioration from gestational hypertension to pe. antiplatelet drugs have moderate benefits when used for prevention of pe. treatment of pIh depends on blood pressure levels, gestational age, presence of symptoms and associated risk factors. non-drug management is recommended when sbp ranges between 140-149 mmhg or dbp between 90-99 mmhg. blood pressure thresholds for drug management in pregnancy vary between different health organizations. according to 2013 esh/esc guidelines, antihypertensive treatment is recommended in pregnancy when blood pressure levels are ≥150/95 mmHg. Initiation of antihypertensive treatment at values ≥140/90 mmHg is recommended in women with a) gestational hypertension, with or without proteinuria, b) pre-existing hypertension with the superimposition of gestational hypertension or c) hypertension with asymptomatic organ damage or symptoms at any time during pregnancy. methyldopa is the drug of choice in pregnancy. atenolol and metoprolol appear to be safe and effective in late pregnancy, while labetalol has an efficacy comparable to methyldopa. angiotensin-converting enzyme (ace) inhibitors and angiotensin II antagonists are contraindicated in pregnancy due to their association with increased risk of fetopathy.

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“…Compared with calcium channel blockers, hydralazine may be a less effective antihypertensive and associated with more maternal side effects [315][316][317][318]. Compared with parenteral labetalol, hydralazine may be a more effective antihypertensive but associated with more maternal hypotension and maternal side effects [315,319,320]; however, labetalol is associated with more neonatal bradycardia that may require intervention [315,319,321].…”

Section: Antihypertensive Therapymentioning

confidence: 99%