A comparative randomized controlled parallel group study of efficacy and tolerability of labetalol versus methyldopa in the treatment of mild preeclampsia

Authors

  • Shubha Singhal Department of Pharmacology, Government Medical College, Patiala, Punjab, India
  • Anita K. Gupta Department of Pharmacology, Government Medical College, Patiala, Punjab, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20150011

Keywords:

Preeclampsia, Methyldopa, Labetalol

Abstract

Background: The objective of the current study was to compare the efficacy and tolerability of labetalol versus methyldopa in the treatment of mild preeclampsia.

Methods: We carried out a prospective randomized controlled parallel group study on 100 outpatients of Obstetrics and Gynaecology Department of Government Medical College, Patiala, a tertiary care teaching hospital. Pregnant patients (20-40 weeks gestational age) newly diagnosed with blood pressure (BP) of ≥140/90 mm Hg were included in the study. All patients with systolic BP (SBP) ≥160 mm Hg and diastolic BP (DBP) ≥110 mm Hg after 20 weeks of gestation, history of hypertension, renal diseases, diabetes mellitus, epilepsy, and thyroid diseases were excluded from the study. After taking the informed consent, 50 patients each were randomized to either of the two treatment arm-oral labetalol or oral methyldopa. Difference in the BP measurements at the time of admission and at the time of delivery were analyzed by applying paired t-test. For intergroup analysis, we applied independent t-test using SPSS version 16. A p<0.05 was regarded as significant.

Results: Both methyldopa and labetalol cause significant fall in SBP, DBP and mean arterial pressure (MAP) in their groups (p<0.001). However, when we compared both groups it was labetalol, which causes significant fall in MAP as compared to methyldopa (p<0.001). The incidence of adverse effects like hypotension, headache, and sedation were also less in labetalol group.

Conclusion: Labetalol has an upper edge over methyldopa in control of BP during pregnancy with minimal adverse effects.

Metrics

Metrics Loading ...

References

Hezelgrave NL, Duffy SP, Shennan AH. Preventing the preventable: pre-eclampsia and global maternal mortality. Obstet Gynaecol Reprod Med. 2012;22(6):171-2.

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.

Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol. 2009;33(3):130-7.

Osungbade KO, Ige OK. Public health perspectives of preeclampsia in developing countries: implication for health system strengthening. J Pregnancy. 2011;2011:481095.

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

Lunell NO, Hjemdahl P, Fredholm BB, Nisell H, Persson B, Wager J. Circulatory and metabolic effects of a combined alpha- and beta-adrenoceptor blocker (labetalol) in hypertension of pregnancy. Br J Clin Pharmacol. 1981;12(3):345-8.

Pickles CJ, Symonds EM, Broughton Pipkin F. The fetal outcome in a randomized double-blind controlled trial of labetalol versus placebo in pregnancy-induced hypertension. Br J Obstet Gynaecol. 1989;96(1):38-43.

Harper A, Murnaghan GA. Maternal and fetal haemodynamics in hypertensive pregnancies during maternal treatment with intravenous hydralazine or labetalol. Br J Obstet Gynaecol. 1991;98(5):453-9.

Mahmoud TZ, Bjornsson S, Calder AA. Labetalol therapy in pregnancy induced hypertension: the effects on fetoplacental circulation and fetal outcome. Eur J Obstet Gynecol Reprod Biol. 1993;50(2):109-13.

Sawhney G, Dabhadkar S, Nimbargi V. Comparative study of labetalol and methyldopa in management of preeclampsia. Indian J Appl Res. 2013;3(1):146-7.

Montan S, Anandakumar C, Arulkumaran S, Ingemarsson I, Ratnam SS. Effects of methyldopa on uteroplacental and fetal hemodynamics in pregnancy-induced hypertension. Am J Obstet Gynecol. 1993;168:152-6.

Elhassan EM, Mirghani OA, Habour AB, Adam I. Methyldopa versus no drug treatment in the management of mild pre-eclampsia. East Afr Med J. 2002;79(4):172-5.

Lamming GD, Symonds EB. Use of labetalol and methyldopa in pregnancy-induced hypertension. Br J Clin Pharmacol. 1979;8 Suppl 2:217S-22.

el-Qarmalawi AM, Morsy AH, al-Fadly A, Obeid A, Hashem M. Labetalol vs. methyldopa in the treatment of pregnancy-induced hypertension. Int J Gynaecol Obstet. 1995;49(2):125-30.

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 Res. 2012;2(1):L23-31.

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(9):868-76.

Downloads

Published

2017-01-18

How to Cite

Singhal, S., & Gupta, A. K. (2017). A comparative randomized controlled parallel group study of efficacy and tolerability of labetalol versus methyldopa in the treatment of mild preeclampsia. International Journal of Basic & Clinical Pharmacology, 4(3), 442–445. https://doi.org/10.18203/2319-2003.ijbcp20150011

Issue

Section

Original Research Articles