INTRAVENOUS LABETALOL VERSUS INTRAVENOUS HYDRALAZINE IN THE MANAGEMENT OF SEVERE PREECLAMPSIA: A RANDOMISED RECIPIENT-BLINDED CLINICAL TRIAL

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Dr. Shouvik Das
Dr. Isha Sudrania
Dr. Pallab Kumar Mistri
Dr. Nidhi Somani

Abstract

Background: Labetalol and hydralazine are first line anti-hypertensive medications recommended for control of blood pressure in severe preeclampsia.


Objectives:To compare the efficacy and safety of intravenous hydralazine and intravenous labetalol in the management of severe preeclampsia.


Materials and methods: One hundred and thirty pregnant women more than 20 weeks gestation with singleton pregnancy with severe preeclampsia were included in the study and were randomly assigned into two groups (i.e., n= 65 in each group). One group received intravenous labetalol (Group Labetalol) and the other intravenous hydralazine (Group Hydralazine). The outcome was measured and compared in both the groups.


Results: A mean of 22.154 ± 0.710 minutes was required in labetalol group and 24.154 ± 0.756 minutes in hydralazine group to achieve blood pressure control and there was no statistical significance (p = 0.0560). Forty-six (70.77%) women with labetalol and 51 (78.46%) women with hydralazine required 1-2 doses for control of blood pressure (p= 0.4205).


Headache was significantly more frequent in patients given hydralazine than following labetalol (16 vs 2 respectively, p = 0.0006, RR = 0.2). Ten patients given hydralazine had palpitations compared to two patients in labetalol group and this was statistically significant (p = 0.0302, RR = 0.31). Maternal tachycardia was observed in 8 patients (12.31%) in hydralazine group and 1 (1.54%) patient in labetalol group and this was statistically significant (p = 0.0327). Foetal bradycardia was observed more in patients with labetalol than hydralazine (6 vs 2 respectively, p = 0.2735, RR = 1.551). The maternal and foetal outcomes were otherwise similar in both arms of the study.


Conclusion: The present study demonstrated that both labetalol and hydralazine are effective antihypertensive agents in severe preeclampsia. Therefore, the choice between two drugs should be based on criteria such as respective contraindications, cost, availability, and clinician’s experience.


Keywords: Hydralazine; Labetalol; Severe preeclampsia

Published Dec 17, 2022

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