Randomized Controlled Trial of Labetalol Versus Hydralazine for Severe Hypertension in Obstetric Patients.
Hypertension, Pregnancy Induced, Hydralazine Adverse Reaction, Pre-eclampsia
About this trial
This is an interventional treatment trial for Hypertension, Pregnancy Induced focused on measuring Hypertension, Pregnancy induced, Pre-eclampsia, Eclampsia, Labetalol, Hydralazine
Eligibility Criteria
Inclusion Criteria:
INCLUSIONS CRITERIA Pregnant or post partum patients with systolic blood pressure ≥160mm of Hg or diastolic BP ≥110 mm Hg, on repeat measurement of blood pressure after 15 minutes of rest, meeting following inclusion criteria will be included.
- Pregnancy greater than 28 wks(gestational age determined by ultrasound prior to 20 weeks which if unavailable then by uterine size at first prenatal visit or by last menstrual period) with gestational hypertension, severe preeclampsia, chronic hypertension, chronic hypertension with superimposed preeclampsia, eclampsia and unclassified hypertension.
- Postpartum patients, upto 72 hours after delivery, diagnosed as gestational hypertension, severe preeclampsia, chronic hypertension, chronic hypertension with superimposed preeclampsia, eclampsia and unclassified hypertension.
- Patients with singleton or multiple pregnancy.
- Patients of all ages and parity.
Exclusion Criteria:
- Patients with asthma.
- Patients with cardiac failure and heart block.
- Patients with pacing device in place or any type of cardiac arrhythmia. -
Sites / Locations
- Civil Hospital Karachi
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Labetalol
Hydralazine
This group (Group A; Labetalol) receiveD intravenous(IV) labetalol manufactured by Zafa pharmaceutical, 50mg/10 ml ampoule) bolus doses administered over 2 minutes, at 10 minutes interval. Initially dose of 20 mg wAS administered, and if required repeated in increments of 40 mg,80 mg,80 mg,80 mg every 10 minutes till SBP became <160 and DBP <110 mm Hg, upto a maximum cululative dose of 300mg(total 5 bolus doses).During this time pulse and blood pressure were checked every 10 minutes.
This group (Hydralazine;Group B) received intravenous Hydralazine and served control. Bolus doses of 5 mg administered over 2 minutes, at 20 minutes interval. Pulse and blood pressure were checked every 10 minutes interval. If SBP threshold of 160 mm Hg or DBP 110 mm Hg was still reached after 20 minutes, then second bolus was repeated. Similarly if after 20 minutes SBP was still ≥160 or DBP ≥110 mm Hg, then third dose was given. If SBP or DBP thresholds were still exceeded after 20 minutes then similarly 4th and 5th dose of 5 mg were given. Failure to reduce SBP<160 or DBP<110 after consecutive maximum 5 boluses(total 25 mg) was labeled as severe persistent hypertension.