Comparative Study Between Tab. Labetalol and Methyldopa In Treatment Of Pregnancy Induced Hypertension

  • Sultana A Medical Officer (Obstetrics and Gynae), Shaheed Ahsan Ullah Master General Hospital, Tongi, Gazipur, Bangladesh
  • Begum T Senior Consultant (Obst and Gynae), Shaheed Ahsan Ullah Master General Hospital, Tongi, Gagipur, Bangladesh
  • Siddique MAB Assistant Professor, Department of Surgery, Shaheed Tajuddin Ahmad Medical College Hospital, Gazipur, Bangladesh
  • Akter A Senior Consultant, (Obstetrics and Gynae), Shaheed Ahsan Ullah Master General Hospital, Tongi, Gagipur, Bangladesh
  • Patuary S Junior Consultant, (Obstetrics and Gynae), Shaheed Ahsan Ullah Master General Hospital, Tongi, Gagipur, Bangladesh
  • Nasrin UT Resident Surgeon (Obst and Gynae), Shaheed Ahsan Ullah Master General Hospital, Tongi, Gagipur, Bangladesh
Keywords: Pregnancy Induced Hypertension, Methyldopa, labetalol

Abstract

Background: Pregnancy induced hypertension is one of the most significant health problem in pregnancy. This is the 2nd most common obstetrics cause of maternal death in Bangladesh. It is the leading cause of infant morbidity and mortality. Objective: To compare the efficacy of two drugs, labetalol and methyldopa as an antihypertensive to control of blood pressure.

Methodology: A randomized controlled trial carried among 100 pregnant women pregnancy induced hypertension (PIH) attending Obstetrics & Gynaecology Department Dhaka Medical College & Hospital during the period of November 2010 to April 2011. 50 patients treated with tab. Labetalol (Group A) and 50 treated with tab. Methyldopa (Group B). Results: Finding of the study showed mean age, gestational age and occupation did no differ significantly variation between Labetalol (group A) and Methyldopa (group B). Among 36% had gestational HTN, 62% had preeclampsia and 2% had eclampsia in group A. On the other hand in group B 32% had gestational HTN, 64% had preeclampsia and 4% had eclampsia. Among 23 patients in group A (46%) went in normal whereas (32%) went in normal vaginal delivery in group B. Maternal morbidity was more in group B than group A. The most common morbidity were pulmonary oedema (6%) in group A and 14% had pulmonary oedema in group B. At the time of discharge, in group A 85.41% patients had normal blood pressure and 95.83% patients had no protenuria. Whereas in group B 80.43% had normal blood pressure and 91.30% had no proteinuria. Incidence of still birth was more in methyldopa group (group B). Low birth weight was lower with labetalol group (group A).

Conclusion: It concluded that labetalol is more advantageous than methyldopa in terms of better and quicker control of blood pressure. The chances of normal vaginal delivery were greater in the labetalol group than in the methyldopa group.

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References

1. David A, Miller MD. Hypertension in pregnancy. In: Alam H eds. Current diagnosis and Treatment, obstetrics and Gynaecology 10th ed. Lange Medical Publication 2007:318-26.
2. Walker JJ. Preeclampsia. Lancet 2000;356: 1260-5.
3. World Health Organization. WHO International collaborate study of hypertensive disorders of pregnancy, geographic variation in the incidence of hypertension in pregnancy. Am J Obstet Gynecol 2008;158:80-3.
4. Lopez-Jaramillo P. Garcia RG Lopez M. Preventing pregnancy induced hypertension: are there regional differences for this global problem? J Hypertens 2005;23:1121-9.
5. Dutta DC. Hypertensive disorder in pregnancy. In: Koner H ed. Textbook of obstetrics including perinatology and contraception 5th ed. New Central Book Agency (p) Ltd. 2001;233-56.
6. Magee LA, Ornstein MP, Dadelszen P. Management of hypertension in pregnancy. BMJ 1999;318:1332
7. Aris F. Hypertensive disorder in pregnancy. Practical guide to High Risk Pregnancy and Delivery 3rd ed. 2008;397-439
8. Gibson P, Carson MD. Hypertension and pregnancy. Emedecine. Medscape.com/article/261435.
9. Sabour A. High blood pressure in pregnancy & coronary calcification. Hypertension 2007:2:75-80
10. Kincaid-Smith P, Bullen M, Mills J. Prolonged use of methyldopa in severe hypertension in pregnancy. BMJ 2006; 274-76.
11. Sowers JR, Zemel MB, Bronsteen RA, Zemel PC, Walash MF, Standly PR. Sokol RJ. Erythrocyte cation metabolism in preeclampsia. Am J Obstet Gynecol 1989;161(2):441-445.
12. Jaramillo PL. Casas JP, Serrano N. Preeclampsia from epidemiological observation to molecular mechanism. Bart J Med Biol 2001;95
13. Ganong WF. Hormonal control of calcium metabolism and the physiology of bone, In: Review of Medical Physiology, 12th ed. New York; Mcgraw Hill Companies, Buston 2001;369-382. 26.
14. Roberts JM, Redman CW. Pre-eclampsia: more than pregnancy-induced hypertension. Lancet. 1993 Jun 5,341(8858):1447-51.
15. Subhedar V, Inamdar S, Hariharan C, Subhedar S. Comparison of efficacy of labetalol and methyldopa in patients with pregnancy-induced hypertension. International Journal of Reproduction, Contraception. Int J Reprod Contracept Obstet Gynecol. 2013;2(1):27-34 28.
16. 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; 49:125-30.
17. Lamming GD & Symonds EM. Use of Labetalol and Methyldopa in Pregnancy-Induced Hypertension. Br J Clin Pharmacol. 2009;8:2178-228.
18. Michael CA. Use of labetalol in the treatment of severe hypertension during pregnancy. Br J Clin Pharmacol 2009; 8:2118-58.
19. 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.
20. Cruickshank DJ, Robertson AA, Campbell DM, MacGillivray 1. Does labetalol influence the development of proteinuria in pregnancy hypertension? A randomised controlled study. Eur J Obstet Gynecol Reprod Biol 1992;45:47-51.
21. 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 2003;4(Suppl G):35-40.
22. Michael CA. Use of labetalol in the treatment of severe hypertension during pregnancy. Br J Clin Pharmacol 2009; 8:211S-5S.
23. Rosenthal T. Oparil S. The effect of antihypertensive drugs on the fetus. J Hum Hypertens 2002; 16:293-298.
24. Podymow T, August P, Update on the use of antihypertensive drugs in pregnancy. Hypertension 2008; 51:960-969.
25. El-Qarmalawi AM, Morsy AH, Al-Fadly A, Obeid A, Hashem M., Labetalol vs. methyldopa in the treatment of pregnancy-induced hypertension. Int J Gynecol Obstet 1995;49(2):125-130.
26. 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):109-113. 39.
27. 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, CD002252.
How to Cite
Sultana, A., Begum, T., Siddique , M. A. B., Akter, A., Patuary, S., & Nasrin, U. tania. (2024). Comparative Study Between Tab. Labetalol and Methyldopa In Treatment Of Pregnancy Induced Hypertension. Obs Gyne Review: Journal of Obstetric and Gynecology, 10(1), 25-31. Retrieved from https://obstetrics.medresearch.in/index.php/joog/article/view/170
Issue
Vol 10 No 1 (2024): Jan-Dec
Section
Original Article

Copyright (c) 2024 Author (s). Published by Siddharth Health Research and Social Welfare Society

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