A randomized trial of intravenous labetalol AND oral nifedipine in severe pregnancy induced hypertension

Background: Hypertension is the most frequently encountered medical disorder in obstetrics practice & remain a major cause of maternal, fetal & neonatal morbidity & mortality. The present study was undertaken to compare the time taken to reach the therapeutic goal blood pressure after using intravenous labetalol & oral nifedipine in severe pregnancy induced hypertension. Methods: Randomly allocated patients received labetalol 20 mg initially, followed by escalating doses of 40, 80, 80 & 80 mg & a placebo tablet every 20 minutes or initially nifedipine tablet 10 mg orally with repeated doses of 20 mg every 20 minutes up to 5 doses & intravenous placebo 0.9% isotonic saline until the therapeutic goal blood pressure, Systolic ? 150 mmHg & diastolic ? 100 mmHg was achieved. Primary and secondary outcomes like the time interval required to achieve a blood pressure of ?150/100 mmHg and urinary output, agent failure & adverse effects respectively were reported. Results: Patients received oral nifedipine achieved the goal therapeutic blood pressure more rapidly in 28.2±11.7 minutes (mean±SD) as compared with 48.4±23.5 minutes in those received intravenous labetalol (p=0.001). The nifedipine group also required significantly fewer doses (3.5±0.5 vs 4.5±1.5; p=0.001) to reach the goal blood pressure. Urine output was significantly increased (p