Comparison of Efficacy of Oral Nifedipine Versus Intravenous Labetalol in the Acute Management of Hypertensive Urgency of Pregnancy

Abstract

Objective: To compare the oral nifedipine efficacy with intravenous labetalol in hypertensiveurgency of pregnancy.

Materials and methods: A total of 220 patients with sudden arterial hypertension who were 18 to 38 years old and had singleton gestations over 24 weeks were enrolled in this study. Patients with multiple pregnancies, heart disease, asthma, last child birth>4 years old, and those allergic to nifedipine orlabetalol were excluded. The selected patients were randomly divided into two groups by balloting: Group A (oral nifedipine) and Group B (intravenous labetalol). For positive or negative results, variable results (efficacy) such as blood pressure control were observed within two hours of starting treatment.

Results: The mean age of women in group A was 24.24 ± 3.38 and in group B was 23.18 ± 4.05 years (p<0.0001). The mean gestational age in group A was 34.75 ± 3.11 weeks and in group B was 33.98 ± 3.87 weeks (p<0.0015). There was normalization of blood pressure within two hours in 93 (84.55%) patients in Group A while in Group B, it was seen in 77 (70.0%) patients. So, efficacy was 84.55% in group A (oral nifedipine) and 70.0% in group B (IV Labetalol) with p-value of 0.0003. The mean time for blood pressure control was 26.87 ± 9.22 and 45.54 ± 16.91 for oral nifedipine and IV labetalol group respectively with a p-value <0.0001.

Conclusion: Oral nifedipine can be used as a first-line antihypertensive drug for the emergency treatment of hypertensive urgency of pregnancy.

Keywords: Pregnancy-induced hypertension, blood pressure control, oral nifedipine, intravenous labetalol.