Comparison of intravenous labetalol and hydralazine for severe hypertension in pregnancy in Northeastern Nigeria: A randomized controlled trial.

Autor: Muhammad S; Department Of Obstetrics and Gynaecology State Specialist Hospital Gombe, Gombe State PMB 018, Nigeria. Electronic address: sagir.muhammad@npmcn.edu.ng., Usman H; Department Of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, Nigeria., Dawha YM; Department Of Obstetrics and Gynaecology Federal Teaching Hospital Gombe, Nigeria., Yahya A; Department Of Obstetrics and Gynaecology, College of Medical Sciences, Ahmadu Bello University/ Ahmadu Bello University Teaching Hospital, Zaria, Nigeria., Yekeen A; Cardiology Unit, Department of Internal Medicine, Gombe State University, Nigeria., Bako B; Department of Obstetrics and Gynaecology, Gombe State University, Gombe, Nigeria.
Jazyk: angličtina
Zdroj: Pregnancy hypertension [Pregnancy Hypertens] 2022 Aug; Vol. 29, pp. 1-6. Date of Electronic Publication: 2022 May 08.
DOI: 10.1016/j.preghy.2022.05.001
Abstrakt: Objectives: The objectives were to compare the efficacy and safety of intravenous hydralazine and labetalol for acutely lowering severe hypertension in pregnancy.
Study Design: This was a superiority parallel double-blinded randomized controlled trial conducted from October 2018 to June 2019 in two hospitals in Gombe, Nigeria. Pregnant women with a live singleton fetus at gestational age of at least 28 weeks with severe hypertension were randomized (60 per group) to receive incremental doses of either intravenous labetalol (20 mg; 40 mg; 80 mg; 80 mg; and 80 mg) or 10 mg of intravenous hydralazine - up to a maximum of 5 doses - until the target blood pressure was achieved or the study was terminated.
Main Outcome Measures: The main outcome measures were the mean reduction in mean arterial blood pressure and occurrence of persistent hypertension. Other endpoints were maternal side-effects, perinatal death, Apgar score at birth and SCBU admission.
Results: One hundred and thirteen patients' data were analyzed (fifty-six [56] in the hydralazine group and fifty-seven [57] in the labetalol group). There were no significant differences in the fall of the mean arterial blood pressure (labetalol; 24.19 mmHg/hydralazine; 27.68 mmHg) (p = 0.192), maternal side effects, perinatal deaths, Apgar scores and SCBU admission between the two groups. Hydralazine, however, produced a more marked reduction in diastolic blood pressure than labetalol (p = 0.012).
Conclusion: Both labetalol and hydralazine are effective for acute blood pressure control in pregnancy with a similar safety profile. This study was self-funded and registered in the Pan African Clinical Trials Registry (www.pactr.orgPACTR202010738538062).
(Copyright © 2022 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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