ORAL NIFEDIPINE AND INTRAVENOUS LABETALOL FOR HYPERTENSIVE EMERGENCIES IN PREGNANCY : A COMPARATIVE STUDY

Background: - Hypertensive emergency in pregnancy is defined as persistent acute-onset, severe hypertension (Systolic BP >160 mmHg or diastolic BP >110 mmHg or both) in the setting of preeclampsia or eclampsia. Objective - Compare safety and efficacy of oral nifedipine and intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy Study design – a randomised comparative hospital based study conducted in Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur from April 2018 to Nov 2018. Sample - 80 women with hypertensive emergencies Method- Divided into 2 groups of 40 each. Nifedipine grp received 10mg tab every 20 min till maximum of 5 doses and labetalol grp was given iv labetalol in escalating doses of 20, 40, 40,80 and 80mg every 20 min till a target BP was achieved. Main outcome measures – Better treatment for Hypertensive emergencies of pregnancy Results – In our study, mean time required to achieve target BP in nifedipine and labetalol group was 45+14.84 and 54+18.22 minutes (p value 0.018) respectively. Mean decrease in SBP after treatment was 59 ± 21.1 mmHg in Nifedipine group as compared to 42.25 ± 22.7 mmHg in Labetalol (p-value = 0.001). Also the mean decrease in DBP in nifedipine group was 37.5 ± 11.49 mmHg as compared to 27.75 ± 15.34 mmHg in labetalol group(p-value = 0.001). There were no significant differences between side effects and fetomaternal outcome. Conclusion- Oral Nifedipine controls hypertension more rapidly and with fewer doses and is as safe as iv Labetalol.