A prospective, parallel group, open label, observational study to compare efficacy and feto-maternal outcomes in treatment of pregnancy induced hypertensive patients
Keywords:Anti-hypertensive, Perinatal, Pregnancy induced hypertension
Background: Pregnancy induced hypertension (PIH) is defined as elevation in blood pressure 140/90 mmHg or greater after 20 weeks of gestation on two occasions more than 4 hours apart in a newly diagnosed patients. Complications of pregnancy are the major health problems leading to maternal and perinatal mortality and morbidity. Some anti-hypertensive drugs are commonly used to control hypertension.
Methods: A prospective, parallel group, open label observation study was carried out at SVS Medical Hospital, Mahabubnagar. Patients were divided into three groups based on severity of hypertension and the drug used for treatment.
Results: Of 120 patients diagnosed with PIH majority (50%) of women were in the age group of 21-24 years with 33-37 gestational age. In the present study there was a significant reduction in BP after the treatment with Labetalol when compare to Nifedepine and Methyldopa. Although, all the three groups have shown significant reduction in BP during 24 hrs treatments and the mean time to achieve target BP was shown less in Labetalol group when compare to Methyldopa and Nifedepine and the maximum doses required to achieve target BP was in between 4-6 doses/day. 40% of complication observed was HELLP syndrome.
Conclusions: Our study coincides with the previous findings that labetolol is an efficacious and safer drug for use in control of PIH and mean time required to achieve target BP is low when compared to nifedipne and methyldopa.
Watanabe K, Naruse K, Tanaka K, Suzuki Y. Outline of definition and classification of Pregnancy induced Hypertension (PIH). Hypertension Res Pregnancy. 2013;1:3-4.
Helewa ME, Burrows RF, Smith J, Williams K, Brain P, Rabkin SW. Report of the Canadian Hyperten-sion Society Consensus Conference: 1. Definitions, evaluation and classification of hypertensive disorders in pregnancy. CMAJ. 1997;157:715-25.
Rezaei Z, Sharbaf FR, Pourmojieb M, Youefzadeh-Fard Y, Motevalian M, Khazaeipour Z, et al. Comparison of the Efficacy of Nifedipine and Hydralazine in Hypertensive Crisis in Pregnancy. Acta Medica Iranica. 2011;49(11):
Diseased Extm Emergency Medicine Clinical Reviews, Hypertension In Pregnancy. Thomson Micromedex: Micromedex Healthcare Series Available at: http;//www.thomsonhc.com/librarian/ ND_PR/Main/…/hcs. Accessed on 13 June 2006.
Grujic I, Milasinovic L. Hypertension, pre-eclampsia and eclampsiamonitoring and outcome of pregnancy. Med Pregl. 2006;59(11-12):556-9.
Naden RP, Redman CW. Antihypertensive drugs in pregnancy. Clin Pernatol. 1985;12(3):521-38.
Ferrao MH, Pereira AC, Gersgorin HC, Paula TA, Correa RR, Castro EC. Treatment effectiveness of hypertension during pregnancy. Rev Assoc Med Bras. 2006;52(6):390-4.
Fabry IG, Richart T, Chengz X, Van Bortel LM, Staaessen JA. Diagnosis and treatment of hypertensive disorders during pregnancy. Act Clin Belg. 2010;65(4):229-236.
Magee LA, Helewa M, Moutquine JM, von Dadelszen P. Diagnosis, evaluation and management of the hypertensive disorders of pregnancy. JOGC. 2008;30(3):1-31.
Dharwadkar MN, Kanakamma MK, Dharwadkar SN, Rajagopal K, Gopakumar C, Divya James Fenn J, et al. Methyldopa Versus Labetalol in Management of Preeclampsia and Gestational Hypertension. Gynecol Obstetrics. 2014;4:9.
Alabdulrazzaq F, Koren G, FRCPC FACMT, Canadian Family Physician • Le Médecin de famille canadien Juillet 2012.
Saxena S, Srivastava PC, Thimmaraju KV, Mallick AK, Dalmia K, Das B. Socio-demographic Profile of Pregnancy Induced Hypertension in a TertiaryCare Centre. Scholars J Applied Med Sci. 2014;2(6):3081-6.
Babbar K. A comparative study of efficacy of antihypertensive drugs, and feto-maternal outcome, in the treatment of pregnancy induced hypertension. Int J Reprodcontracept Obstet Gynecol. 2015;4(6);1846-52.
Thakur V. Comparison of effect of nifedipine, labetalol and methyldopa in treatment of hypertension in pregnancy in a tertiary care government hospital. Int J Reprod Contracept Obstet Gynecol. 2016;5(1):1-7.
Kavitha Reddy K. Maternal outcome in pregnancy induced hypertension in a teaching hospital in rural area in telangana. J Evidence Based Med Healthcare. 2016;3(77):4171-4.