COMPARISON OF HYDRALAZINE AND LABETALOL IN THE MANAGEMENT OF HYPERTENSIVE DISORDERS OF PREGNANCY

Abstract

Objective: To compare the efficacy of intravenous hydralazine and intravenous labetalol for acutely lowering blood pressure in pregnancy.

Study Design: Randomized control trial (RCT).

Place and Duration of Study: M.C.H center, Unit I PIMS, Islamabad, one year from June 2011-June 2012.

Material and Methods: In this randomized control trial 80 patients with gestational hypertension were enrolled systematically randomizing 40 each to inj Labetalol and inj Hydralazine groups. The study was conducted in the Department of Obstetrics & Gynaecology, Maternal and Child Health Centre, Unit I, Pakistan Institute of Medical Sciences, Islamabad and was completed in one year. The study included indoor patients with hypertensive disorders of pregnancy, monitored in high dependency area admitted through Emergency and OPD. The outcome measures include adequate control of hypertension.

Results: Labetalol was more effective than Hydralazine in lowering diastolic BP in the first hour from the baseline BP (p-value 0.009). 19 (47%) patients in Labetalol and 8 (20%) patients in hydralazine had a reduction in diastolic BP. However the reduction of diastolic BP in second and third hours was not significant (p values 0.446, 0.314) . In the fourth hour the diastolic BP fell to less than 100 mm of Hg in both the group. Patients in Hydralazine group suffered more headache as compared to Labetalol (p-value = 0.043 and Chisquare value = 4.114). Similarly the incidence of tachycardia was more in hydralazine group (p value =0, Chi square value 23.226).

Conclusions: The efficacy (Diastolic BP ≤ 100 mm of Hg) of Labetalol in the first hour was was highly significant as compared to Hydralazine group whereas the efficacy in the second, 3rd and 4th hour were not significant. Labetalol is affordable, readily available and has minimal side effects than Hydralazine.