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Short-term treatment of severe hypertension of pregnancy: prospective comparison of nicardipine and labetalol.
Intensive Care Med. 2002 Sep; 28(9):1281-6.IC

Abstract

OBJECTIVES

To assess the efficacy and safety of nicardipine in comparison to labetalol in the initial management of severe hypertension in pregnancy. DESIGN. Randomized prospective study.

SETTING

The obstetric ward of the teaching hospital of Monastir Tunisia.

PATIENTS

Sixty consecutive pregnant women admitted beyond the 24th week of pregnancy with severe hypertension.

INTERVENTION

Patients were randomly assigned to receive intravenously for 1 h either labetalol (n=30) or nicardipine (n=30). Treatment was titrated to achieve a 20% lowering of blood pressure (BP).

MEASUREMENTS

Maternal BP and heart rate were measured at inclusion and repeatedly during the first hour following the drugs administration. Fetal heart rate was recorded throughout the study period. The main outcome endpoints were the success rate and the length of time needed to achieve the therapeutic goal. The rate of maternal and fetal adverse events and dose adjustments were also analyzed.

RESULTS

Labetalol and nicardipine achieved the 20% lowering in BP in the same proportion (63% and 70% success rates, respectively). Overall nicardipine caused a significantly greater decrease in systolic and diastolic BP. No patient had any episode of hypotension. The length of time to achieve the BP goal was also similar (12 vs. 11 min, respectively). Both drugs were well tolerated except for a moderate tachycardia observed with the use of nicardipine.

CONCLUSION

Nicardipine and labetalol are effective and safe in the initial treatment of severe hypertension of pregnancy.

Authors+Show Affiliations

Elatrous S
Intensive Care Unit F, Service de Réanimation polyvalente, Bourguiba Hospital, Monastir, Tunisia. Atrous.souheil@gnet.tn
Nouira S
No affiliation info available
Ouanes Besbes L
No affiliation info available
Marghli S
No affiliation info available
Boussarssar M
No affiliation info available
Sakkouhi M
No affiliation info available
Abroug F
No affiliation info available

MeSH

AdultAntihypertensive AgentsFemaleHumansHypertensionLabetalolNicardipinePre-EclampsiaPregnancyPregnancy Complications, CardiovascularProspective StudiesTreatment OutcomeTunisia

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

12209278

Citation

Elatrous, S, et al. "Short-term Treatment of Severe Hypertension of Pregnancy: Prospective Comparison of Nicardipine and Labetalol." Intensive Care Medicine, vol. 28, no. 9, 2002, pp. 1281-6.
Elatrous S, Nouira S, Ouanes Besbes L, et al. Short-term treatment of severe hypertension of pregnancy: prospective comparison of nicardipine and labetalol. Intensive Care Med. 2002;28(9):1281-6.
Elatrous, S., Nouira, S., Ouanes Besbes, L., Marghli, S., Boussarssar, M., Sakkouhi, M., & Abroug, F. (2002). Short-term treatment of severe hypertension of pregnancy: prospective comparison of nicardipine and labetalol. Intensive Care Medicine, 28(9), 1281-6.
Elatrous S, et al. Short-term Treatment of Severe Hypertension of Pregnancy: Prospective Comparison of Nicardipine and Labetalol. Intensive Care Med. 2002;28(9):1281-6. PubMed PMID: 12209278.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short-term treatment of severe hypertension of pregnancy: prospective comparison of nicardipine and labetalol. AU - Elatrous,S, AU - Nouira,S, AU - Ouanes Besbes,L, AU - Marghli,S, AU - Boussarssar,M, AU - Sakkouhi,M, AU - Abroug,F, Y1 - 2002/07/26/ PY - 2001/10/15/received PY - 2002/06/07/accepted PY - 2002/9/5/pubmed PY - 2002/12/27/medline PY - 2002/9/5/entrez SP - 1281 EP - 6 JF - Intensive care medicine JO - Intensive Care Med VL - 28 IS - 9 N2 - OBJECTIVES: To assess the efficacy and safety of nicardipine in comparison to labetalol in the initial management of severe hypertension in pregnancy. DESIGN. Randomized prospective study. SETTING: The obstetric ward of the teaching hospital of Monastir Tunisia. PATIENTS: Sixty consecutive pregnant women admitted beyond the 24th week of pregnancy with severe hypertension. INTERVENTION: Patients were randomly assigned to receive intravenously for 1 h either labetalol (n=30) or nicardipine (n=30). Treatment was titrated to achieve a 20% lowering of blood pressure (BP). MEASUREMENTS: Maternal BP and heart rate were measured at inclusion and repeatedly during the first hour following the drugs administration. Fetal heart rate was recorded throughout the study period. The main outcome endpoints were the success rate and the length of time needed to achieve the therapeutic goal. The rate of maternal and fetal adverse events and dose adjustments were also analyzed. RESULTS: Labetalol and nicardipine achieved the 20% lowering in BP in the same proportion (63% and 70% success rates, respectively). Overall nicardipine caused a significantly greater decrease in systolic and diastolic BP. No patient had any episode of hypotension. The length of time to achieve the BP goal was also similar (12 vs. 11 min, respectively). Both drugs were well tolerated except for a moderate tachycardia observed with the use of nicardipine. CONCLUSION: Nicardipine and labetalol are effective and safe in the initial treatment of severe hypertension of pregnancy. SN - 0342-4642 UR - https://www.unboundmedicine.com/medline/citation/12209278/Short_term_treatment_of_severe_hypertension_of_pregnancy:_prospective_comparison_of_nicardipine_and_labetalol_ DB - PRIME DP - Unbound Medicine ER -