Comparative evaluation of oral labetalol, nifedipine and amlodipine in the management of postpartum preeclampsia: a prospective randomized study

Abstract

Background: Postpartum preeclampsia is a major contributor to maternal morbidity and mortality worldwide. Persistent hypertension during the postpartum period can lead to severe complications such as stroke, pulmonary edema, renal dysfunction, and eclampsia if not managed appropriately. Oral antihypertensive agents including labetalol, nifedipine, and amlodipine are commonly used for postpartum blood pressure control; however, comparative evidence regarding their efficacy and tolerability remains limited.

Methods: A prospective randomized comparative study was conducted over a period of 12 months in the Department of Obstetrics and Gynecology at a tertiary care hospital. A total of 120 women diagnosed with postpartum preeclampsia were randomly allocated into three equal groups of 40 patients each. Group A received oral labetalol, group B received oral nifedipine, and group C received oral amlodipine. Patients were monitored for blood pressure control, time required to achieve target blood pressure, requirement of additional antihypertensive therapy, duration of hospital stay, and adverse drug reactions.

Results: All three drugs effectively reduced postpartum blood pressure. Nifedipine showed the fastest reduction in systolic and diastolic blood pressure and least requirement for additional antihypertensive therapy. Amlodipine demonstrated smoother blood pressure control with better tolerability, whereas labetalol was effective but required more frequent dosing. Duration of hospital stay was shortest in the nifedipine group.

Conclusions: Oral nifedipine, labetalol and amlodipine are effective antihypertensive agents in postpartum preeclampsia. Nifedipine demonstrated rapid blood pressure control, whereas amlodipine provided sustained control with better compliance and fewer adverse effects.