Study of labetalol vs. methyldopa in treatment of pregnancy induced hypertension

Bhakti G. Gurjar, Samidha S. Malewar


Background: Hypertension is a common medical problem encountered during pregnancy and is associated with increased risk of adverse outcomes. Objective of this study was to compare efficacy and safety of Labetalol and Methyldopa in controlling blood pressure in patients with PIH and pre-eclampsia.

Methods: A comparative, prospective observational, single centre study conducted from November 2015 to November 2017 in women with PIH at Indira Gandhi Government Medical College, Nagpur. Group A included 100 patients treated with Labetalol while Group B included 100 patients who were given Methyldopa. Response in lowering of BP was assessed over a period of 7 days.

Results: Labetalol treated group of patients showed significant fall from 143.50±7.30mmHg/101.30±3.93 (sytolic/diastolic) on 1st day to 126.10±5.49 mmHg/87.40±5.62 mmHg (sytolic/diastolic) on day 7, while systolic/diastolic BP in methyldopa group on 1st day was 145.20±7.17 mmHg/101.60±4.20 mmHg which was reduced to 129.20±4.86 mmHg/90.50±3.30 mmHg on day 7. Author found that MAP in Labetalol group reduced from 115.226±4.17 mmHg to 100.17±4.43 mmHg on day 7 while in Methyldopa group had MAP on admission 115.99±4.38 mmHg and on day 7 it reduced to 103.27±2.99mmHg which is highly significant.

Conclusions: Labetalol controls systolic and diastolic blood pressure more rapidly and effectively than Methyldopa. Safety profile and adverse effects of Labetalol and Methyldopa are similar to each other.


Labetalol, Methyldopa, Pregnancy induced hypertension

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Arias F, Daftary SN, Bhide AG. Hypertensive disorders of pregnancy. In: Dasgupta S, Nasim S, Khanna M (Eds.) Practical guide to high-risk pregnancy and delivery- a South Asian perspective (3rd edn.), Elsevier Publication, New Delhi; 2008:397-439.

Duley L, Henderson-Smart DJ, Meher S. Drugs for treatment of very high blood pressure during pregnancy. Cochrane Database Syst Rev. 2006:CD001449.

Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Preeclampsia. Lancet. 2010;376:631-44.

Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005;330:565.

Hernández-Diaz S, Van Marter LJ, Werler MM, Louik C, Mitchell AA. Risk factors for persistent pulmonary hypertension of the newborn. Pediatrics. 2007;120:e272-282.

Saftlas AF, Logsden-Sackett N, Wang W, Woolson R, Bracken MB. Work, leisure-time physical activity, and risk of preeclampsia and gestational hypertension. Am J Epidemiol; 2004;160:758-65.

Skjaerven R, Vatten LJ, Wilcox AJ, Rønning T, Irgens LM. Recurrence of pre-eclampsia across generations: exploring fetal and maternal genetic components in a population based cohort. BMJ. 2005;331:877.

Abalos E, Duley L, Steyn DW, Henderson-Smart DJ. Antihypertensive drug therapy for mild to moderatehypertension during pregnancy. Cochrane Database Syst Rev. 2007;1:CD002252.

Lamming GD, Symonds EM. Use of Labetalol and Methyldopa in pregnancy induced hypertension. Br J Clin Pharmac. 1979;8:217S-222S.

ACOG Committee on Obstetric Practice. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. Am College Obstet Gynecol. Int J Gynaecol Obstet. 2002;77:67-75.

Williams Obstetrics: Cunningham, Leveno, Bloom, Sponge, Dashe, Hoffman, Casey, Sheffield: Obstetrical Complications: Hypertensive Disorders; ch.40:729-779.

Lomte D. An open label, prospective, single centre study to evaluate the efficacy of Methyldopa and Labetalol in treatment of patients with pregnancy- inducedhypertension. 2015;4:1235-41.

Sushrut D, Girija. Labetalol an emerging first line drug for pregnancy induced hypertension. Indian J Clin Pract. 2013;23;640-1.

Krishnachetty B, Plaat F. Management of hypertensive disorders of pregnancy. Anaesthesia Tutorial Week. 2014;304:1-13.

Jinturkar A, Khedkar V, Dongaonkar D. Comparison of efficacy of Labetalol and Methyldopa in patients with Pregnancy Induced Hypertension. Int J Recent Trends Sci Techn. 2010;10(3):520-6.

Dharwadkar MN, Kanakamma MK, Dharwadkar SN, Rajagopal K, Gopakumar C, et al. Study of methyl dopa versus labetalol in management of preeclampsia and gestational hypertension. Gynecol Obstet. 2014;4:242.

Pentareddy MR, Shailendra D, Prasuna G, Subbaratnam Y, Naresh DTV, Katta R. Safety and efficacy of Methyldopa and Labetalol in controlling blood pressure in hypertensive disorders of pregnancy. Int J Basic Clin Pharmacol. 2017;6;942-7.

Qasim A, Siddiqui MH, Salam JU, Nusrat U. Labetalol versus Methyldopa: efficacy in pregnancy induced hypertension. Gomal J Med Sci. 2014;12:233-6.

El-Qarmalawi AM, Morsy AH, Al-Fadly A, Obeid A, Hashem M. Labetalol vs Methyldopa in the treatment of pregnancy-induced hypertension. Int J Gynecol Obstet. 1995;49:125-30.

Wallin JD, Wilson D, Winer N, Maronde RF, Michelson EL, Langford H, et al. Treatment of severe hypertension with Labetalol compared with Methyldopa and furosemide. Am J Med. 1983;75(4A):87-94.

Subhedar V, Inamdar S, Hariharan C, Subhedar S. Comparison of efficacy of Labetalol and Methyldopa in patients with pregnancy-induced hypertension. Int J Reprod Contracept Obstet Gynecol. 2013;2(1):27-34.

Friedlander WJ. The history of modern epilepsy: The beginning, 1865-1914. Westport, CT: Greenwood Press; 2001.

Hans SF, Kopelman H. Methyldopa in treatment of severe toxaemia of pregnancy. BMJ. 1964;1:736-9.

Cruickshank DJ, Robertson AA, Campbell DM, MacGillivray I. Does Labetalol influence the development of proteinuria in pregnancy hypertension? A randomised controlled study. Eur J Obstet Gynecol Reprod Bio. 1992;45:47-51.

Lardoux H, Gerard J, Blazquez G, Chouty F, Flouvat B. Hypertension in pregnancy: evaluation of the two B blockers atenolol and Labetalol. Eur Heart J. 1983;4(Suppl G):35-40.

Michael CA. Use of Labetalol in the treatment of severe hypertension during pregnancy. Br J Clin Pharmacol. 1979;8:211S-5S.