Effectiveness of Oral Nifedipine Versus Intravenous Labetalol in Controlling Hypertension in Severe Preeclampsia: A Comparative Study.

BACKGROUND

This study aimed to study and compare the efficacy and side effects between oral nifedipine and intravenous labetalol in controlling hypertension in acute cases of severe preeclampsia.  Methods: A prospective comparative study of pregnant patients with blood pressure >160/110 mm Hg after 20 weeks of gestation was conducted in the Department of Obstetrics and Gynecology of MGM Medical College and Hospital, Navi Mumbai, India, over a period of one and a half years from August 1, 2022, to December 31, 2023. A total of 100 cases were studied, 50 receiving oral nifedipine and the other 50 receiving intravenous labetalol.

RESULTS

Though intravenous labetalol and oral nifedipine both are equally efficacious first-line anti-hypertensive drugs, oral nifedipine was observed to have a quicker onset of action, with a lesser number of doses required to reach the target blood pressure, with a convenient route of administration. Thus, it can be preferred in settings where intravenous access is challenging, remote or low-resource settings, or patients who prefer oral medication. Additionally, nifedipine works as a uterine relaxant, shown to increase urine output, has no effect on pulmonary vasculature, has fewer side effects, and costs 0.5% of the overall cost for intravenous labetalol.

CONCLUSION

Oral nifedipine could be a better choice between the two for treating hypertensive emergencies; however, the decision should be individualized, considering patient-specific factors, clinical setting, and resource availability.