Drug management of hypertensive disorders of pregnancy

Khedun, S M; Moodley, J.; Naicker, Tricia; Maharaj, B

doi:10.1016/s0163-7258(97)82005-0

Cited by 43 publications

(30 citation statements)

References 236 publications

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“…A wide spectrum of antihypertensive agents represents the key of successful pregnancy hypertension treatment and opportunity of choice, in accordance with indications and availability of drugs provided by drug tendering. [5][6][7] In this backdrop, a study was designed to compare the antihypertensive drugs -methyldopa, nifedipine versus labetalol versus in pregnancy induced hypertension (PIH) in tertiary care referral institute.…”

Section: Introductionmentioning

confidence: 99%

A comparative study of efficacy of antihypertensive drugs andfeto-maternal outcome in the treatment of pregnancy induced hypertension

Babbar¹,

Armo²,

Bhanja

2015

Int J Reprod Contracept Obstet Gynecol

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Background: Hypertensive disorders are the most common medical disorders in pregnancy contributing significantly to maternal and perinatal mortality and morbidity worldwide. The incidence is around 3-10% of all pregnancies. The aim of antihypertensives is to reduce, stabilize the blood pressure and thus minimize the risks such as placental abruption, maternal cardiac failure, cerebral hemorrhage; but they should not have any adverse effects on the uteroplacental circulation and the fetus. Antihypertensive drugs are often used to lower blood pressure to prevent this progression to adverse outcomes for the mother and the fetus. The risk of developing severe hypertension is reduced to half by using antihypertensive medications. The aim and objectives of the study was a comparative study of the efficacy of methyldopa, nifedipine versus labetalol and the feto-maternal outcome in gestational hypertension in a tertiary care referral centre. Methods: A prospective study on 240 outpatients as well as inpatients of the antenatal ward of Obstetrics and Gynaecology department of Chhattisgarh Institute of Medical Sciences, Bilaspur which is a tertiary care referral hospital. The patients randomly divided in three groups. The first group received alpha-methyl dopa 250mg tds, second 20 mg bd nifedipine and the third one labetalol 100mg bd. Mean arterial pressure calculated by systolic BP +2 DBP/3.The fall in BP calculated along with time required, dose of drug required, spontaneous/ induced labour or caesarean section, adverse maternal and the fetal outcome was observed. Results: Maximum number of patients that is 145(60.42%) patients belonged to the age group of 19 to 24 years and were primigravida (70.42%) presenting at 33-37 weeks of gestation. Significant fall in MAP was seen in patients receiving nifedipine and labetalol. Mean time to control blood pressure is 46.32 hrs in methyldopa group, 30.44hrs in nifedipine group and 37.24 hrs in labetalol group. 103 (42.9%) patients had normal delivery whereas 137 (57.1%) required a caesarian section, higher rate of spontaneous labour in nifedipine and labetalol group. Most common sideeffect observed was headache; the other side effects included drowsiness, more in patients treated with methyldopa, weakness, more in patients treated with labetalol. The fetal outcome was better with labetalol and nifedipine than methyl-dopa group. Conclusions: The decreased association from maternal and fetal side-effects, the comparatively better hypotensive action indicates that labetalol and nifedipine is suitable for use during pregnancy. Labetalol is safer, quicker in achieving adequate control of blood pressure with considerable prolongation of the duration of pregnancy with fewer side effects on the mother as well as the neonate when used in the management hypertensive disorders of pregnancy.

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Section: Introductionmentioning

confidence: 99%

A comparative study of efficacy of antihypertensive drugs andfeto-maternal outcome in the treatment of pregnancy induced hypertension

Babbar¹,

Armo²,

Bhanja

2015

Int J Reprod Contracept Obstet Gynecol

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“…Three antihypertensive drugsnifedipine, methyldopa and labetalol have been demonstrated to be safe for use in the pregnant women and are commonly used for the management of various hypertensive disorders during pregnancy. [10][11][12][13][14][15] Nifedipine is a calcium channel blocker. Methyldopa is a centrallyacting adrenergic antagonist that acts by stimulation of the central alpha 2 receptors, leading to a decrease in sympathetic nerve activity with resultant arterial dilatation ABSTRACT Background: Pregnancy-induced hypertension is associated with various adverse fetal and maternal outcomes.…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation of antihypertensive drugs in the management of pregnancy-induced hypertension

Patel

Gadhavi

Gorasia

et al. 2012

Int J Basic Clin Pharmacol

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Background: Pregnancy-induced hypertension is associated with various adverse fetal and maternal outcomes. The use of anti-hypertensive drugs in pregnancy is controversial. We conducted a prospective study to evaluate the comparative effectiveness and safety of nifedipine, methyldopa and labetalol monotherapy in patients with pregnancy-induced hypertension. Methods: A total of 60 pregnant women with blood pressure of 140/90 mm Hg or more with ≥1+ proteinuria between 20 and 38 weeks of gestation were randomly allocated to receive nifedipine (n=20), methyldopa (n=20) or labetalol (n=20). Blood pressure was measured at 0, 6, 24, 48 and 72 h of initiation of antihypertensive drugs. Patients were also followed up for development of adverse drug effects during this period. Results: Antihypertensive treatment with methyldopa was associated with reduction in systolic blood pressure (SBP) by 50 mmHg and diastolic blood pressure (DBP) by 30 mmHg at 72 h. For the same period treatment with nifedipine was associated with reduction in SBP by 54 mmHg and DBP by 30 mmHg. Treatment with labetalol was associated with reduction in SBP by 70 mmHg and DBP by 36 mmHg at 72 h. Conclusions: Labetalol was more effective than methyldopa and nifedipine in controlling blood pressure in patients with pregnancy-induced hypertension while methyldopa and nifedipine are equally effective in controlling blood pressure. [Int J Basic Clin Pharmacol 2012; 1(3.000): 174-177

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“…Laboratory findings; hemograme was normal, Worldwide, incidence of pre-eclampsia is 5-14 percent of all pregnancies. In developing nations, incidence of pre-eclampsia is 4-18 percent [2,3]. Severe pre-eclampsia can develop to approximately 25 percent of all cases of pre-eclampsia [4].…”

Section: Abstract: Severe Preeclampsia; Postpartum; Complicationsmentioning

confidence: 99%