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Comparison of intravenous labetalol and hydralazine for severe hypertension in pregnancy in Northeastern Nigeria: A randomized controlled trial.
Pregnancy Hypertens. 2022 Aug; 29:1-6.PH

Abstract

OBJECTIVES

The objectives were to compare the efficacy and safety of intravenous hydralazine and labetalol for acutely lowering severe hypertension in pregnancy.

STUDY DESIGN

This was a superiority parallel double-blinded randomized controlled trial conducted from October 2018 to June 2019 in two hospitals in Gombe, Nigeria. Pregnant women with a live singleton fetus at gestational age of at least 28 weeks with severe hypertension were randomized (60 per group) to receive incremental doses of either intravenous labetalol (20 mg; 40 mg; 80 mg; 80 mg; and 80 mg) or 10 mg of intravenous hydralazine - up to a maximum of 5 doses - until the target blood pressure was achieved or the study was terminated.

MAIN OUTCOME MEASURES

The main outcome measures were the mean reduction in mean arterial blood pressure and occurrence of persistent hypertension. Other endpoints were maternal side-effects, perinatal death, Apgar score at birth and SCBU admission.

RESULTS

One hundred and thirteen patients' data were analyzed (fifty-six [56] in the hydralazine group and fifty-seven [57] in the labetalol group). There were no significant differences in the fall of the mean arterial blood pressure (labetalol; 24.19 mmHg/hydralazine; 27.68 mmHg) (p = 0.192), maternal side effects, perinatal deaths, Apgar scores and SCBU admission between the two groups. Hydralazine, however, produced a more marked reduction in diastolic blood pressure than labetalol (p = 0.012).

CONCLUSION

Both labetalol and hydralazine are effective for acute blood pressure control in pregnancy with a similar safety profile. This study was self-funded and registered in the Pan African Clinical Trials Registry (www.pactr.orgPACTR202010738538062).

Authors+Show Affiliations

Department Of Obstetrics and Gynaecology State Specialist Hospital Gombe, Gombe State PMB 018, Nigeria. Electronic address: sagir.muhammad@npmcn.edu.ng.Department Of Obstetrics and Gynaecology, University of Maiduguri Teaching Hospital, Nigeria.Department Of Obstetrics and Gynaecology Federal Teaching Hospital Gombe, Nigeria.Department Of Obstetrics and Gynaecology, College of Medical Sciences, Ahmadu Bello University/ Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.Cardiology Unit, Department of Internal Medicine, Gombe State University, Nigeria.Department of Obstetrics and Gynaecology, Gombe State University, Gombe, Nigeria.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

35605426

Citation

Muhammad, Sagir, et al. "Comparison of Intravenous Labetalol and Hydralazine for Severe Hypertension in Pregnancy in Northeastern Nigeria: a Randomized Controlled Trial." Pregnancy Hypertension, vol. 29, 2022, pp. 1-6.
Muhammad S, Usman H, Dawha YM, et al. Comparison of intravenous labetalol and hydralazine for severe hypertension in pregnancy in Northeastern Nigeria: A randomized controlled trial. Pregnancy Hypertens. 2022;29:1-6.
Muhammad, S., Usman, H., Dawha, Y. M., Yahya, A., Yekeen, A., & Bako, B. (2022). Comparison of intravenous labetalol and hydralazine for severe hypertension in pregnancy in Northeastern Nigeria: A randomized controlled trial. Pregnancy Hypertension, 29, 1-6. https://doi.org/10.1016/j.preghy.2022.05.001
Muhammad S, et al. Comparison of Intravenous Labetalol and Hydralazine for Severe Hypertension in Pregnancy in Northeastern Nigeria: a Randomized Controlled Trial. Pregnancy Hypertens. 2022;29:1-6. PubMed PMID: 35605426.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of intravenous labetalol and hydralazine for severe hypertension in pregnancy in Northeastern Nigeria: A randomized controlled trial. AU - Muhammad,Sagir, AU - Usman,Hadiza, AU - Dawha,Yahaya Musa, AU - Yahya,Anisah, AU - Yekeen,Ayoola, AU - Bako,Babagana, Y1 - 2022/05/08/ PY - 2021/12/03/received PY - 2022/04/23/revised PY - 2022/05/01/accepted PY - 2022/5/24/pubmed PY - 2022/8/10/medline PY - 2022/5/23/entrez KW - Hydralazine KW - Labetalol KW - Nigeria KW - Pregnancy KW - Severe hypertension SP - 1 EP - 6 JF - Pregnancy hypertension JO - Pregnancy Hypertens VL - 29 N2 - OBJECTIVES: The objectives were to compare the efficacy and safety of intravenous hydralazine and labetalol for acutely lowering severe hypertension in pregnancy. STUDY DESIGN: This was a superiority parallel double-blinded randomized controlled trial conducted from October 2018 to June 2019 in two hospitals in Gombe, Nigeria. Pregnant women with a live singleton fetus at gestational age of at least 28 weeks with severe hypertension were randomized (60 per group) to receive incremental doses of either intravenous labetalol (20 mg; 40 mg; 80 mg; 80 mg; and 80 mg) or 10 mg of intravenous hydralazine - up to a maximum of 5 doses - until the target blood pressure was achieved or the study was terminated. MAIN OUTCOME MEASURES: The main outcome measures were the mean reduction in mean arterial blood pressure and occurrence of persistent hypertension. Other endpoints were maternal side-effects, perinatal death, Apgar score at birth and SCBU admission. RESULTS: One hundred and thirteen patients' data were analyzed (fifty-six [56] in the hydralazine group and fifty-seven [57] in the labetalol group). There were no significant differences in the fall of the mean arterial blood pressure (labetalol; 24.19 mmHg/hydralazine; 27.68 mmHg) (p = 0.192), maternal side effects, perinatal deaths, Apgar scores and SCBU admission between the two groups. Hydralazine, however, produced a more marked reduction in diastolic blood pressure than labetalol (p = 0.012). CONCLUSION: Both labetalol and hydralazine are effective for acute blood pressure control in pregnancy with a similar safety profile. This study was self-funded and registered in the Pan African Clinical Trials Registry (www.pactr.orgPACTR202010738538062). SN - 2210-7797 UR - https://www.unboundmedicine.com/medline/citation/35605426/Comparison_of_intravenous_labetalol_and_hydralazine_for_severe_hypertension_in_pregnancy_in_Northeastern_Nigeria:_A_randomized_controlled_trial. DB - PRIME DP - Unbound Medicine ER -