RESULTS
We randomised 80 pregnant women with hypertensive emergency ( 40 in each
group ) to receive oral Nifedipine in group A and iv Labetalol in group
B.
In our study, the mean age in nifedipine group was 26.4 ± 4.65 years and
in labetalol group was 25.3 ± 5.03 years. Most of the patients were
primigravidas with 52.5% and 60% in nifedipine and labetalol group
respectively . Also the mean gestational age in Group-A was 33.17 ± 3.9
weeks and in Group-B was 34 ± 3.86 weeks. Thus both the groups did not
differ significantly in mean age, gravidity and gestational age.(Table
1)
The Mean Systolic BP in Group-A was 187.2 ± 19.48 mmHg and in Group-B
was 183.8 ± 20.96 mmHg (p-value = 0.442) whereas the mean DBP in Group-A
and Group-B was 119.5 ± 11.31 mmHg and 114.8 ± 14.85 mmHg respectively
p-value = 0.112). There was no significant statistical difference in
mean SBP and mean DBP in both the groups (Table 1)
In our study, it was found that Nifedipine required significantly fewer
doses and less time to achieve target BP than Labetalol. The mean dose
required in nifedipine group to achieve target BP was 2.25 ± 0.74 and in
Labetalol group was 2.7 ± 0.91 which was found to be statistically
significant (p-value = 0.018). The mean time required to achieve target
BP in Nifedipine and Labetalol group was 45.00 ± 14.84 min and 54.00 ±
18.22 min respectively which was also found to be statistically
significant (p-value = 0.018). Mean decrease in SBP after treatment was
59 ± 21.1 mmHg in Nifedipine group as compared to 42.25 ± 22.7 mmHg in
Labetalol (p-value = 0.001). Also the mean decrease in DBP in nifedipine
group was 37.5 ± 11.49 mmHg as compared to 27.75 ± 15.34 mmHg in
labetalol group(p-value = 0.001). This difference in mean decrease in
SBP and DBP was found to be statistically significant. Thus decrease in
systolic BP and diastolic BP after treatment was more in nifedipine
group as compared to labetalol group. (table 2 )
Side effects of drugs on mother
and fetus were transient and tolerable and were comparable in both the
groups .5% cases in Group-A and 10% cases in Group-B complained of
headache. Drowsiness was also seen in 5% and 10% cases in Group-A and
Group-B respectively. 5% cases in both groups complained of nausea.
Postural hypotension was reported in 2.5% cases in Group-A.(table 3)
Regarding mode of delivery , vaginal and caesarean delivery rates were
35% and 25% in nifedipine group and 40% and 30% in labetalol group
and there was no significant difference found between the groups(p-value
= 0.642)(table 4).
There was no significant difference found in fetal outcome in both
groups. 17.5% and 25% babies in Group-A and Group-B respectively had
APGAR score < 7(p value 0.585) The number of NICU admission
was 15% in Group-A as compared to 12.5% in Group-B (p value 0.99).The
cause of NICU admissions were prematurity and meconium aspiration. There
was no perinatal mortality reported in the study.(table 5)