Comparison of Labetalol and Methyldopa's Effectiveness in Treating Hypertension in Pregnancy
DOI:
https://doi.org/10.51699/ijhsms.v2i11.2808Abstract
Background: A significant number of the population lacks access to healthcare in an Iraq-like country, despite the country's constant growth and development in the healthcare sector, the rate of fatal maternal deaths is still high.
The most common medical issue during pregnancy is high blood pressure. On a global scale, 6-8% of pregnancies are said to have been complicated by high blood pressure. Antihypertensive treatments are frequently utilized to lower the blood pressure in order to prevent the pressure from increasing to a level that would negatively affect the mother or baby. Using anti-hypertensive drugs reduces the likelihood of developing severe high blood pressure by half. Therefore, the goals of this study were to determine how well labetalol and methyldopa manage blood pressure in PIH patients and to look into the effects of pregnancy and the perinatal period.
Methods: 180 PIH patients were split into two groups at random. Following random assignment, group A was given 250 mg of methyldopa every other day, and group B was given 100 mg of labetalol. The formula employed to calculate the average pressure in the arteries (MAP) was 2 + 3.5 diastolic BP /6. Patients were monitored for signs of hypotension every six hours. Every day, the MAPs of the two groups were calculated to assess the effectiveness of a particular medicine. Observations regarding the drop in blood pressure with Labetalol/ Methyldopa were documented. the average amount of medication necessary to regulate blood pressure, the beginning of labor--induced or spontaneous--Bishop's initial score during the onset of labor's effects on drugs.
Results: The MAP of patients on labetalol decreased significantly. The average time required in group A to control B.P. was Group B had an average sleep duration of 36.97 hours, compared to group A's 42.22 hours. In the present study, group A's average Bishop score at induction was 8.27, but group B's was 9.33. The statistical analysis revealed a significant difference between the two groups, with p<0.05. In group B, 23 patients, or 48.94 percent of the patients, had spontaneous labor experience; in group A, 33.33 percent of the patients experienced spontaneous labor.
Final thoughts: Because of its effective hypotensive effect and lack of negative side effects on either the mother or the baby, labatalol is safe during childbirth.
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References
Chauhan R, Sharma RS, Parashar MK, Chauhan VS. Clinical examination of hypertension in pregnancy. In: Shah MR, editor. Hypertensive disorders in pregnancy: 1st ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2007. p. 111-25.
Arias F, Daftary SN, Bhide AG. Hypertensive disorders of pregnancy. In: Dasgupta S, Nasim S, Khanna M, editors. Practical guide to high-risk pregnancy and delivery-a South Asian perspective: 3rd ed. New Delhi: Elsevier Publication; 2008. p. 397-439.
Magee LA, Ornstein MP, Dadelszen P. Fortnightly review: management of hypertension in pregnancy. BMJ 1999;318:1332-6.
Shah MR. PIH: The Challenge. In: Shah MR, editor. Hypertensive disorders in pregnancy: 1st ed. New Delhi: Jaypee Brothers Medical Publishers (P) Ltd; 2007. p.19.
Abalos E, Duley L, Steyn DW, Henderson-Smart DJ, et al. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev 2007;(1):CD002252.
Podymow T, August P. Update on the use of antihypertensive drugs in pregnancy. Hypertension 2008;51:960-9.
Brown MA, Hague WM, Higgins J, et al. The detection, investigation and management of hypertension in pregnancy: executive summary. Consensus statement from the Australasian Society for the Study of Hypertension in Pregnancy. Aust N Z J Obstet Gynaecol 2000;40:133-8.
Lamming GD & Symonds EM. Use of Labetalol and Methyldopa in Pregnancy-Induced Hypertension. Br J Clin Pharmacol. 1979; 8:217S22S.
El-Qarmalawi AM, Morsy AH, al-Fadly A, Obeid A, Hashem M, et al. Labetalol vs. methyldopa in the treatment of pregnancy-induced hypertension. Int J Gynaecol Obstet 1995;49:125-30.
Sanders GL, Davies DM, Gales GM, Rao JG, Rawlins MD, Routledge PA. A comparative study of methyldopa and labetalol in the treatment of hypertension. Br J Clin Pharmacol 1979;8:149S51S.
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 Biol 1992;45:47-51.
Lardoux H, Gerard J, Blazquez G, Chouty F, Flouvat B. Hypertension in pregnancy: evaluation of the two B-blockers atenalol 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.
Hans SF, Kopelman H. Methyldopa in treatment of severe toxaemia of pregnancy. BMJ 1964;1:736-9.
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 Pharma Res 2012;2:L23-31.