ABSTRACT
OBJECTIVE: To assess the efficacy and safety of labetalol compared with methyldopa in the management of mild and moderate cases of pregnancy-induced hypertension (PIH). METHODS: One hundred four primigravidas with PIH were randomly allocated to receive either labetalol (group A) or methyldopa (group B). The dose of the drugs was doubled every 48 h to maintain a mean arterial blood pressure < or = 103.6 mmHg. Clinico-biochemical effects and frequency of side effects were studied. The statistical level of significance was taken at P < 0.05. RESULTS: Ten patients in group B (18.5%) developed significant proteinuria (> 30 mg/dl) whereas none developed proteinuria in group A. Labetalol was quicker and more efficient at controlling blood pressure, having a beneficial effect on renal functions and causing fewer side effects compared with methyldopa. The rate of induction of labor and rate of cesarean section for uncontrolled PIH was less in group A (48% and 1%, respectively) compared with group B (63.0% and 5.6%, respectively). Moreover a higher Bishop score at induction of labor was noticed in group A. CONCLUSIONS: Labetalol is better tolerated than methyldopa, gives more efficient control of blood pressure and may have a ripening effect on the uterine cervix.
Subject(s)
Hypertension/drug therapy , Labetalol/therapeutic use , Methyldopa/therapeutic use , Pre-Eclampsia/drug therapy , Pregnancy Complications, Cardiovascular/drug therapy , Adult , Blood Pressure/drug effects , Cesarean Section , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Hypertension/diagnosis , Infant, Newborn , Kuwait , Labetalol/adverse effects , Labor, Induced , Methyldopa/adverse effects , Pre-Eclampsia/diagnosis , Pregnancy , Pregnancy Complications, Cardiovascular/diagnosisABSTRACT
We report a 27-year-old XY female who presented with abdominal pain due to hemoperitoneum from a ruptured abdominal mass. Gonadoblastoma overgrown by endodermal sinus tumor and dysgerminoma was detected. The risk of neoplasia in such cases is discussed.
