Oral antihypertensive regimens for management of severe hypertension in pregnancy: a randomized trial comparing nifedipine, labetalol and methyldopa
THE PROBLEM:
-What is the best/safest oral medication to treat severely elevated blood pressure in pregnancy for mom and baby?
- This is needed as high blood pressure in pregnancy is relatively common and dangerous; in addition, many resource-constrained settings cannot treat intravenously.
WHERE:
-Two hospitals in Nagpur India
WHAT DID WE DO:
-Evaluated 3 different oral medications for high blood pressure
- 10mg of nifedipine – 298 pregnant women received nifedipine
- 200mg of labetalol – 295 pregnant women received labetalol
- 1000mg of methyldopa – 301 pregnant women received methyldopa
WHO WAS INCLUDED:
-894 pregnant women (≥28 weeks’ gestation) randomized
-These pregnant women had a systolic blood pressure ≥160mmHg or diastolic blood pressure ≥110mmHg
OUTCOME OF INTEREST:
-Achieving a systolic blood pressure of 120-150mmHg and a diastolic blood pressure 70-100mHg at 6 hours without an adverse outcome or fetal compromise.