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- DOI 10.18231/j.ijogr.v.12.i.3.24
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CrossMark
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:
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Chethy Sudeepthi
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Aruna Mallangouda Biradar *
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Shobha Shiragur
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Shreedevi Kori
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Preeti Malapure1
Aruna Mallangouda Biradar *
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.
References
- Sharma M, Thakur S, Singh K, Shekhar S. Comparative maternal outcomes of oral nifedipine and intravenous labetalol for severe hypertension during pregnancy: an open label randomized controlled trial. Int J Reprod Contracept Obstet Gynecol. 2020;9(7):2847–51.
- Easterling T, Mundle S, Bracken H, Parvekar S, Mool S, Magee LA, et al. Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial. Lancet. 2019;394(10203):1011–21.
- Agasti N, Kar K. A comparative study between oral labetalol and nifedipine in hypertensive diseases of pregnancy. IOSR J Dent Med Sci. 2021;20(2):47–52.
- Li L, Xie W, Xu H, Cao L. Oral nifedipine versus intravenous labetalol for hypertensive emergencies during pregnancy: a systematic review and meta-analysis. J Matern Fetal Neonatal Med. 2023;36(2):2235057.
- Wang W, Xie X, Yuan T, Wang Y, Zhao F, Zhou Z, et al. Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population- based study. BMC Pregnancy Childbirth. 2021;21(1):364. Sudeepthi et al. / Indian Journal of Obstetrics and Gynecology Research 2025;12(3):511–515 515
- Odigboegwu O, Pan LJ, Chatterjee P. Use of Antihypertensive drugs during preeclampsia. Front Cardiovasc Med. 2018;5:50.
- Dey R, Mukhopadhyay A, Biswas SC, Chakrabarti SC, Monda J, Soren S. Intravenous labetalol versus oral nifedipine for acute blood pressure control in severe pregnancy-induced hypertension- A randomised trial. J Evolution Med Dent Sci. 2017;6(92):6578–82.
- Verma M, Gupta S, Bhagat BR, Mahajan A, Kaur B. Comparison of intravenous hydralazine and intravenous labetalol in the management of severe hypertensive disorders of pregnancy: a tertiary care centre study. Int J Reprod Contracept Obstet Gynecol. 2018;7(6):2251-6.
- Rose DT, Jeyarani P. Comparative study of labetalol and nifedipine in management of non- severe preeclampsia and its fetomaternal outcome. Int J Reprod Contracept Obstet Gynecol. 2019;8(5):2034–
- Alam A, Zakaria SMA. Oral Nifedipine versus intravenous Labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomised controlled trial. Int J Reprod Contracept Obstet Gynecol. 2019;8(5):1921–57.
- Biswas SK, Raha SK. Oral Nifedipine versus intravenous labetalol for acute blood pressure control in severe hypertension of pregnancy: A study at faridpur medical college hospital. Faridpur Med Coll J. 2021;16(1):25–9.
- Nivethana KB, Priya SS, Karunanithi K. A comparative study of IV labetalol with oral Nifedipine in severe pre-eclampsia. Int J Clin Obstet Gynaecol. 2020;4(1):388–92.
- Sahai R, Nidhi A, Ranjan R, Lal S. Comparative study of oral Nifedipine versus intravenous Labetalol in severe hypertension in pregnancy: A randomised controlled study. Indian J Obstet Gynecol Res. 2020;7(1):75–80.
- Jamil S, Sengupta M, Saha C, Bandhya D, De R, Mitra M, et al. Oral nifedipine versus intravenous labetalol in hypertensive emergencies of pregnancy- A randomised trial. J Evolution Med Dent Sci. 2019;8(48):3588–92.
- Gavit Y, Sharma D, Dixit PV. A comparative study of oral nifedipine and intravenous labetalol in control of acute hypertension in severe pre-eclampsia and eclampsia. Int J Reprod Contracept Obstet Gynecol. 2018;7:719–24.