DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20171109

Safety and efficacy of methyldopa and labetalol in controlling blood pressure in hypertensive disorders of pregnancy

Mary Rohini Pentareddy, Shailendra D., Prasuna G., Subbaratnam Y., Naresh D.T. V., Rajshekar Katta

Abstract


Background: Hypertensive disorders represent the most common medical complication of pregnancy, with a reported incidence of 6-10% and accounts for 15% of maternal mortality. Effective management of pregnancy induced hypertension is vital to improve maternal and foetal outcomes. As data are scarce on comparison of labetolol and methyldopa this study was undertaken. The objective of present study is compare the efficacy and safety of Labetalol versus Methyldopa in the management of Mild to Moderate pregnancy induced hypertension. To evaluate effect of both drugs on maternal and foetal outcomes.

Methods: A comparative observational study is designed. 30 patients who received methyldopa and 30 patients who received labetalol were included in the study. Methyldopa was started at a dose of 250-500 mg thrice daily while labetalol was started at a dose of 100-400 mg twice daily. Patients were followed up during antenatal, intrapartum and postpartum period for efficacy, safety, maternal, and perinatal outcomes.

Results: Methyldopa and Labetalol reduced mean systolic and mean diastolic blood pressures significantly. safety profile of both drugs was similar. Spontaneous vaginal deliveries were observed more with labetolol significantly.

Conclusions: Labetalol is equally efficacious as methyldopa and well tolerated in the treatment of new onset hypertension during pregnancy.


Keywords


Adverse effects, Labetalol, Methyldopa, PIH

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References


Report of the national high blood pressure education program working group on high blood pressure in pregnancy. Am J Obstet Gynecol. 2000;183(1):S1-S22.

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

Magee L, Duley L. Cochrane study group oral beta-blockers for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2003;(3):CD002863.

Goodman & Gilman’s The pharmacological basis of therapeutics.11th ed. 2006:32.

Verma R, Lahon K, Tonpay SD, Kale VJ, Jain DK. A comparative randomised controlled parallel group study of efficacy and tolerability of labetalol versus methyldopa in the treatment of new onset hypertension during pregnancy. Int J Life Sci Pharm. Research. 2012;2:23-31.

Redman CWG, Gallery ED, Mitchell MD. Fall in BP in response to volume expansion in pregnancy associated hypertension (PE): Why does it occur? BMJ. 1984;2(2):177-82.

Sibai BM, Gonzalez AR, Mabie WC, Moretti M. A comparison of labetalol plus hospitalization versus hospitalization alone in the management of preeclampsia remote from term. Obstet Gynecol. 1987;70:323-7.

Plouin PF, Breart G, Maillard F, Papiernik E, Relier JP. Comparison of antihypertensive efficacy and perinatal safety of labetalol and methyldopa in the treatment of hypertension in pregnancy: a randomized controlled trial. Br J Obstet Gynaecol. 1988;95:868-76.

Pickles CJ, Symonds EM, Pipkin FB. The fetal outcome in a randomized double-blind controlled trial of labetalol versus placebo in pregnancy-induced hypertension. Br J Obstet Gynaecol. 1989;96:38-43.

Sibai BM, MabieWC, Shamsa F, Villar MA, Anderson GD. A comparison of no medication versus methyldopa or labetalol in chronic hypertension during pregnancy. Am J Obstet Gynecol. 1990;162(4):960-6.

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.

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;2:27-34.

Lamming GD, Symonds EM. Use of labetalol and methyldopa in pregnancy induced hypertension. Br J Clin Pharmacol. 1979;8:217S-22S.

Lardoux H, Blazquez G, Leperlier E, Gerard J. Randomized, comparative study on the treatment of moderate arterial hypertension during pregnancy: methyldopa, acebutolol, labetalol. Arch Mal Coeur Vaiss. 1988;81:137.

Patel NK, Gadhavi M, Gorasia D, Pandya MR. Comparative evaluation of antihypertensive drugs in the management of pregnancy-induced hypertension. Int J Basic Clin Pharmacol. 2012;1:174-7.