DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20182010

Comparison of maternal outcome in patients treated with methyldopa and labetalol in the management of hypertensive disorders of pregnancy

Harish K. M., Shwetha N., Dipankar Debnath

Abstract


Background: To compare the maternal outcome in patients treated with methyldopa and labetalol in the management of moderate to severe hypertensive disorders of pregnancy (HDP).

Methods: The present study is Prospective parallel group comparative study on 200 out-patients and inpatients selected between January 2013 to December 2013 from OPD and antenatal ward of Obstetrics and Gynaecology department, of tertiary care teaching hospital, Regional Institute of Medical Sciences, Imphal. 100 patients each were distributed to methyldopa group and labetalol group respectively.

Results: There was statistically significant reduction in the mean systolic BP + Standard deviation / Diastolic BP + Standard deviation and Mean arterial pressure (MAP) in Labetalol group (from 156.84 + 5.75/100.20 + 6.02 mmHg and 119.08 + 4.07 to 133.76 + 3.50/85.14 + 3.98 mmHg and 101.35 + 2.94) compared to Methyldopa group (from 156.00 + 6.581/100.96 + 6.896mmHg and 119.30 + 4.86 to 137.20 + 2.36/89.02 + 2.38mmHg and 105.08 + 1.78). Risk of adverse effects was less in Labetalol group (12%) but complication during pregnancy was more in Methyldopa group (51%). Number of spontaneous onset of labour and vaginal mode of delivery was more in Labetalol group.

Conclusions: The present study shows that primiparity, residing in rural area, with low income group and overweight are at high risk of developing Hypertensive Disorders of Pregnancy. Labetalol is the better drug in controlling blood pressure with less adverse effects and maternal complication.


Keywords


Hypertensive disorders of pregnancy, Labetalol, Methyldopa

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References


World health organization. Trend in maternal mortality: 1990 to 2008. Geneva: WHO, 2010. Available at http://whqlibdoc.who.int/publication/2010/9789241500265_eng.pdf. .

Sharma A, Poonam M, Bisht S. Management of pregnancy induced hypertension. IJRAP. 2010;1: 390-98.

Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy. Am J Obstet Gynecol. 2000;183:S1-22.

Arulkumaran S, Gopalan S, Kumar P. Obstetrics and Gynecology for Postgraduates. Universities Press 2009. 3rd ed; 271-89.

Begum F, Parveen T. Antihypertensive in hypertensive disorder of pregnancy. Bangladesh J Obstet Gynaecol. 2008;23;65-72.

FG Cunningham, KJ Leveno, SL Bloom, JC Hauth, DJ Rouse, CY Spong. Williams Obstetrics. McGraw Hill. 23rd ed;706-7.

National Institute for Health and Care Excellence. Hypertension in Pregnancy: The Management of Hypertensive Disorders During Pregnancy. NICE clinical guideline 107. London: NICE; 2010.

Barron WM, Murphy MB, Lindheimer MD. In: Management of hypertension during pregnancy. 3rd ed New York: Hypertension pathophysiology, diagnosis and management; 1990.2;1809-27.

Vigil-De Gracia P, Montufar-Rueda C, Ruiz J. Expectant management of severe preclampsia and preeclampsia superimposed on chronic hypertension between 24 and 34 weeks gestation. Eur J Obstet Gynecol Reprod Biol. 2003;107:24-7.

Podymow T, August P. Update on use of anti-hypertensive drugs in pregnancy. American heart Assoc J. 2007;51:960-69.

Sudarsan S, Ghosh RS, Ganguly RP, Das A: Comparative study on the efficacy of magnesium sulphate and diazepam in the management of eclampsia in a peripheral rural medical college (A cross over study of 440 cases). J Obstet Gynecol India. 2002;52:69-72.