A randomized parallel group trial for the comparison of safety and efficacy of oral nifedipine retard versus intravenous labetalol in management of hypertensive emergencies of pregnancy

• Author Details:   
• Chethy Sudeepthi
• Aruna Mallangouda Biradar ^*
• Shobha Shiragur
• Shreedevi Kori
• Preeti Malapure1

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Background: Hypertensive emergencies during pregnancy pose significant risks to both mother and fetus. This study examines the time and dosage needed to achieve target blood pressure levels using two antihypertensive agents: oral Nifedipine retard and intravenous Labetalol. Through a randomized trial, it aims to provide insights into the safety and efficacy of these treatments, enhancing management strategies for hypertensive disorders in pregnancy.

Materials and Methods: A randomized study with 104 pregnant women who had a blood pressure of 160/110 mm Hg or higher compared the effects of Nifedipine (20 mg every 30 minutes, up to five doses) and Labetalol (20 mg, 40 mg, or 80 mg every 15 minutes) until a target blood pressure of 150/100 mm Hg or lower was reached. The main focus was on the time and dosage needed to achieve this goal.

Results: The mean time to achieve target blood pressure was significantly shorter with IV Labetalol (33.85 ± 11.87 minutes) compared to oral Nifedipine (48.56 ± 17.36 minutes; P < 0.0001). The average dose required was lower for Nifedipine (1.73 ± 0.63 mg) than for Labetalol (2.06 ± 0.67 mg; P < 0.01). The total dose needed was higher for Labetalol (70.00 ± 42.57 mg) compared to Nifedipine (33.71 ± 13.14 mg).

Conclusion: Labetalol quickly lowers blood pressure, while oral nifedipine retard is also effective and well tolerated for managing severe hypertension, showing minimal side effects.