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A comparative trial of labetalol and hydralazine in the acute management of severe hypertension complicating pregnancy.
Obstet Gynecol. 1987 Sep; 70(3 Pt 1):328-33.OG

Abstract

Sixty peripartum patients with diastolic blood pressures (BP) 110 mmHg or higher were randomized in a 2:1 ratio to receive repeated intravenous injections of either labetalol (20-80 mg) or hydralazine (5 mg) until the diastolic BP was below 100 mmHg. There were four treatment failures in the labetalol group (N = 40) and none in the hydralazine group (N = 20). Hydralazine lowered mean arterial pressure (MAP) more than did labetalol (33.3 +/- 13.2 versus 25.5 +/- 11.2 mmHg; mean +/- SD), but labetalol had a more rapid effect. There was considerable interpatient variability in the dose of labetalol required to control BP, which could not be predicted by any clinical characteristic before therapy. The duration of action also varied in the labetalol group, with the shortest duration occurring in those patients who required the highest dosage for BP control. No significant fetal or neonatal problems ascribable to drug treatment were noted in the 13 instances in which labetalol was given before delivery. However, fetal distress occurred in two of the six cases involving antenatal hydralazine. We conclude that labetalol appears to be a safe and effective alternative to hydralazine for treating hypertension in the peripartum period, but serious rare side effects have not yet been quantified.

Authors

Mabie WC
No affiliation info available
Gonzalez AR
No affiliation info available
Sibai BM
No affiliation info available
Amon E
No affiliation info available

MeSH

AdultBlood PressureClinical Trials as TopicDose-Response Relationship, DrugFemaleHumansHydralazineHypertensionLabetalolPre-EclampsiaPregnancyPregnancy Complications, CardiovascularRandom Allocation

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

3306494

Citation

Mabie, W C., et al. "A Comparative Trial of Labetalol and Hydralazine in the Acute Management of Severe Hypertension Complicating Pregnancy." Obstetrics and Gynecology, vol. 70, no. 3 Pt 1, 1987, pp. 328-33.
Mabie WC, Gonzalez AR, Sibai BM, et al. A comparative trial of labetalol and hydralazine in the acute management of severe hypertension complicating pregnancy. Obstet Gynecol. 1987;70(3 Pt 1):328-33.
Mabie, W. C., Gonzalez, A. R., Sibai, B. M., & Amon, E. (1987). A comparative trial of labetalol and hydralazine in the acute management of severe hypertension complicating pregnancy. Obstetrics and Gynecology, 70(3 Pt 1), 328-33.
Mabie WC, et al. A Comparative Trial of Labetalol and Hydralazine in the Acute Management of Severe Hypertension Complicating Pregnancy. Obstet Gynecol. 1987;70(3 Pt 1):328-33. PubMed PMID: 3306494.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A comparative trial of labetalol and hydralazine in the acute management of severe hypertension complicating pregnancy. AU - Mabie,W C, AU - Gonzalez,A R, AU - Sibai,B M, AU - Amon,E, PY - 1987/9/1/pubmed PY - 1987/9/1/medline PY - 1987/9/1/entrez SP - 328 EP - 33 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 70 IS - 3 Pt 1 N2 - Sixty peripartum patients with diastolic blood pressures (BP) 110 mmHg or higher were randomized in a 2:1 ratio to receive repeated intravenous injections of either labetalol (20-80 mg) or hydralazine (5 mg) until the diastolic BP was below 100 mmHg. There were four treatment failures in the labetalol group (N = 40) and none in the hydralazine group (N = 20). Hydralazine lowered mean arterial pressure (MAP) more than did labetalol (33.3 +/- 13.2 versus 25.5 +/- 11.2 mmHg; mean +/- SD), but labetalol had a more rapid effect. There was considerable interpatient variability in the dose of labetalol required to control BP, which could not be predicted by any clinical characteristic before therapy. The duration of action also varied in the labetalol group, with the shortest duration occurring in those patients who required the highest dosage for BP control. No significant fetal or neonatal problems ascribable to drug treatment were noted in the 13 instances in which labetalol was given before delivery. However, fetal distress occurred in two of the six cases involving antenatal hydralazine. We conclude that labetalol appears to be a safe and effective alternative to hydralazine for treating hypertension in the peripartum period, but serious rare side effects have not yet been quantified. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/3306494/A_comparative_trial_of_labetalol_and_hydralazine_in_the_acute_management_of_severe_hypertension_complicating_pregnancy_ DB - PRIME DP - Unbound Medicine ER -