Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomised trial

Raheem, I.A. and Saaid, R. and Omar, S.Z. and Tan, P.C. (2012) Oral nifedipine versus intravenous labetalol for acute blood pressure control in hypertensive emergencies of pregnancy: a randomised trial. BJOG An International Journal of Obstetrics and Gynaecology, 119 (1). pp. 78-85. ISSN 1470-0328

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Official URL: http://onlinelibrary.wiley.com/doi/10.1111/j.1471-...

Abstract

Objective To compare oral nifedipine with intravenous labetalol in their rapidity to control hypertensive emergencies of pregnancy. Design A double-blind randomised trial. Setting A university hospital in Malaysia. Population Pregnant women with severe gestational hypertension >= 160/110 mmHg who required immediate treatment. Methods Patients were randomised to receive nifedipine (10 mg tablet, orally, up to five doses) and intravenous placebo saline injection or intravenous labetalol injection (in an escalating dose regimen of 20, 40, 80, 80 and 80 mg) and a placebo tablet every 15 minutes until the target blood pressure of <= 150/100 mmHg was achieved. Crossover treatment was effected if the initial treatment regimen was unsuccessful. Main outcome measure The time taken to achieve a blood pressure of <= 150/100 mmHg. Results The median time taken to achieve target blood pressure was 30 minutes (interquartile range, IQR 22.5-67.5 minutes) versus 45 minutes (IQR 30-60 minutes) for nifedipine and labetalol, respectively (P = 0.59). Repeated measures analysis of variance indicated that in the first hour both systolic (F = 87.6, P < 0.001) and diastolic (F = 55.8, P < 0.001) blood pressure significantly decreased, but there was no difference between the nifedipine and labetalol groups for both systolic (F = 0.12, P = 0.74) and diastolic (F = 0.92, P = 0.34) blood pressure trends over time. Crossover treatment was required in 20 of women from each group. Conclusions Oral nifedipine and intravenous labetalol regimens are similarly effective in the acute control of severe hypertension in pregnancy.

Item Type: Article
Uncontrolled Keywords: Hypertension;labetalol;nifedipine;pre-eclampsia;pregnancy;trial
Subjects: R Medicine
R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Medicine
Depositing User: Ms Haslinda Lahuddin
Date Deposited: 16 Jul 2014 00:08
Last Modified: 14 Jul 2017 08:24
URI: http://eprints.um.edu.my/id/eprint/10842

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