Pre-operative Preparation of Pre-eclamptic Patients Undergoing Cesarean Section: A prospective randomized comparative study between the effect of Labetalol versus Nifedipine in controlling elevation of blood pressure

Abstract

Background:Pre-eclampsia is a disorder of widespread vascular endothelial malfunction and vasospasm that occurs after 20 weeks' gestation. Aim: This work aimed to compare the anti-hypertensive efficacy of oral Labetalol with oral Nifedipine in mild preeclampsia. Materials and Methods:This study was conducted on a total of 100 antenatal mild full term pre-eclamptic women at Ain-Shams University Maternity Hospital ICU and obstetric theater. They were divided into two groups; first group (group A): oral Labetalol was started with a dose of 200 mg and second group (group B): oral Nifedipine was started at dose of 20 mg. Results: Group B had significantly higher number of side effects when compared to group A. None of the patients developed grave complications such as HELLP syndrome, pulmonary edema, coagulopathy, postpartum collapse, the maternal mortality was nil. Thus when patients with preeclampsia are identified and treated at an earlier stage the morbidity and mortality associated with preeclampsia can be significantly reduced. Conclusion:Both oral labetalol and oral Nifedipine are equally efficacious in the control of hypertension in mild preeclampsia. Regarding the drug side effects and tolerability, labetalol was significantly better than Nifedipine. There was no significant difference in the neonatal outcome between the two groups. Thus, labetalol is a better alternative to Nifedipine,as it had lesser side effect profile. However, in a limited resource setting, Nifedipine is an equally effective, cheap and easily available drug for mild preeclampsia.