Use of labetalol in the treatment of severe hypertension during pregnancy.

Abstract

1 Labetalol, a hypotensive agent combining a-and fl-adrenoceptor antagonist properties, was used to treat severe hypertensive disease complicating pregnancy. 2 Effective reduction in BP was achieved in all but 3 of the 25 patients treated. Careful monitoring of feto-placental function was undertaken to ensure the maintenance of fetal well-being. Maternal and fetal side-effects were minimal and it was not necessary to discontinue the drug in any patient. 3 Labetalol was estimated in the cord blood of the fetus at delivery as well as in the breast milk of mothers on day 3 post partum. There were no adverse effects of the drug on the infants and significant hypotension did not occur. 4 The results suggest that labetalol has a direct action on fetal lung maturation and this, together with its effective hypotensive effect, contributes to the low perinatal mortality (3.5%) observed. 5 Oculotoxicity due to the labetalol was not observed in the infants delivered. 6 It is concluded that the efficient hypotensive action of labetalol, together with apparent freedom from maternal and fetal side-effects, and consequent improved perinatal mortality, suggest that it is a suitable drug for use in pregnancy complicated by hypertension.

The evaluation of labetalol in the treatment of hypertension complicating pregnancy.

“…In a previous study (Michael, 1979a) (Table 2). In all patients treatment was commenced in the middle trimester of pregnancy and continued for a minimum of 1 week and up to a maximum of 19 weeks.…”

“…There is still confusion amongst clinicians concerning treatment and consequently the disease accounts for significant maternal and foetal mortality and morbidity. Despite the confusion recent reports show that control of hypertension in pregnancy by antihypertensive drugs results in better survival (Michael 1975;Redman et al, 1976;Michael, 1979a;Gallery et al, 1979).…”

“…The value of labetalol (Trandate) in the control of hypertension complicating pregnancy with resulting improved foetal survival has already been established (Michael, 1979a). At the King Edward Memorial Hospital for Women, Perth, Australia, labetalol has been the drug of choice since 1979 for those patients with hypertensive disease in pregnancy where the foetus is too immature to consider its delivery.…”

“…At the King Edward Memorial Hospital for Women, Perth, Australia, labetalol has been the drug of choice since 1979 for those patients with hypertensive disease in pregnancy where the foetus is too immature to consider its delivery. This decision was undertaken following clinical trials with the drug (Michael, 1979a), which showed that adequate reduction in blood pressure prevented any cerebral or cardiac complications of the hypertension and allowed pregnancy to safely continue until foetal maturity was reached. This resulted in a reduced foetal loss from prematurity by preventing premature induction of labour for uncontrolled hypertension in the mother.…”

Labetalol, an alpha‐ and beta‐adrenoceptor‐blocking agent: its use in therapeutics. A summary of the symposium.

“…New studies of the use of labetalol in hypertension and toxaemia of pregnancy are encouraging (Michael, 1979;Lamming & Symonds, 1979). Not only does labetalol satisfactorily control BP in pregnant women but may possibly aid the maturation of the fetal lung in utero (Michael;Nicholas, et al, 1978).…”