Comparison of oral nifedipine and oral labetalol as a single drug therapy for control of blood pressure in preeclampsia

Background: Worldwide hypertension during pregnancy is a common cause of maternal and fetal morbidity and mortality. Effective control of blood pressure is one of the important steps in management of preeclampsia. Few drugs like nifedipine, labetalol, methyldopa, and hydralazine have acceptable high safety profile during pregnancy.Methods: In this study 120 antenatal women with non-severe preeclampsia were compared by giving either nifedipine or labetalol as a single drug therapy for control of blood pressure. Various parameters like control of blood pressure, side effects of drugs, gestational age at the time of delivery, mode of delivery, any complication and perinatal outcome were assessed.Results: In this study authors found that in both group, adequate control of blood pressure was achieved. This study shows slightly higher rate of pre term delivery and LSCS with labetalol and minimal side effects with nifedipine but difference in each group is insignificant.Conclusions: Labetalol and nifedipine both the drugs are equally effective in reducing blood pressure and any of it can safely be used as a first choice of drug for management of hypertension in preeclampsia and it can be decided as per clinician’s experience and familiarity with drug.

Comparative study: normotensive and preeclampsia mother presenting with imminent symptoms of eclampsia in third trimester of pregnancy

Background: This prospective study compares the maternal and fetal outcome in normotensive and preeclampsia mother presenting with imminent symptoms of eclampsia in third trimester. This prospective study was conducted in the department of obstetrics and gynaecology, Government Theni Medical College, Tamil Nadu, India in 2019.Methods: A total 100 antenatal mothers were selected for the study. Group A - 50 known case of preeclampsia presented with imminent symptoms. Group B-50 previously normotensive patients present with imminent symptoms of eclampsia. Maternal and fetal outcome were analysed.Results: Incidence of eclampsia - 0.1%, HELLP syndrome - 0.04%, pulmonary edema - 0.06%, PRES - 0.07%, abruptio placenta - 0.14% and maternal death in Group A was 2% and in Group B was 8%. Maternal complications are more in normotensive women (46%) presented with imminent symptoms than in preeclampsia women (26%) with imminent symptoms. Incidence of IUGR in Group A was 46%, whereas in Group B 12%. Incidence of preterm babies in Group A was 18%, whereas in Group B was 42%. Perinatal death incidence was 2.2% in imminent eclampsia.Conclusions: Because known preeclampsia patients were aware of imminent symptoms and presented early to hospital. Early identification and treatment of this dreadful outcome at the imminent state itself can reduce the complications. In current status on preventive aspect of eclampsia, atypical presentation should also be considered for which new screening and diagnostic tools has to be developed.

Comparative study of labetalol and nifedipine in management of non- severe preeclampsia and its fetomaternal outcome

Background: In developed countries, 16 percent of maternal deaths were attributed to hypertensive disorders. Of hypertensive disorders, the preeclampsia syndrome, either alone or superimposed on chronic hypertension, is the most dangerous. The incidence of preeclampsia in nulliparous populations ranged from 3 to 10 percent.Methods: The present study was conducted at Government Raja Mirasudhar Hospital, Thanjavur Medical College, Thanjavur, Tamil Nadu, India from October 2017 to October 2018. The study consisted of 100 antenatal women with non-severe preeclampsia. The efficacy of labetalol verses nifedipine in its management was studied along with the fetomaternal outcome.Results: In this study, in the labetalol and in the nifedipine groups adequate control of blood pressure was achieved. However, labetalol was well tolerated by our women without much side effects.Conclusions: The present study indicates both labetalol and nifedipine are equally efficacious in the control of hypertension in non-severe preeclampsia. Pathology of the disease was not altered significantly in both the groups. There was no significant difference in the neonatal outcome between the two groups.