Assessment and Efficacy of Labetalol and Methyldopa in Controlling Blood Pressure in Patients with Pregnancy Induced Hypertension (PIH)

Background: The most frequent medical disease in pregnancy is hypertension, which contributes considerably to maternal and perinatal mortality and morbidity. It is estimated that hypertension complicates around 6-10% pregnancies. If it remains uncontrolled, it can lead to complications like pre-eclampsia, eclampsia, fetal growth retardation, abruptio placentae, premature delivery and fetal mortality as well as maternal morbidity and the mortality. Hypertension is the most common medical problem encountered during pregnancy. It is estimated that globally 6-8% of pregnancies are complicated by hypertension. The risk of developing severe hypertension is reduced to half by using antihypertensive medications.

Objective: To asses and compare the efficacy of labetalol and methyldopa in controlling blood pressure in patients with pregnancy induced hypertension.

Methods: This study was conducted in the Department of Obstetrics and Gynaecology, Shahid Syed Nazrul Islam Medical College, Kishorgonj, Bangladesh from July 2019 To June 2020. 150 patients with PIH were divided in to two groups randomly. After randomization, group A received methyldopa 250 mg tid and group B received labetalol 100mg tid. Mean Arterial pressure (MAP) was calculated according to formula systolic BP+2 diastolic BP /3. Patients were subjected to 6 hrly BP monitoring. Comparison of two drugs was done daily by calculating MAP of two groups. Following Observations were made as regards Fall in BP with Labetalol/ Methyldopa, Time required to control BP, Average dose of drugs required to control BP, Onset of labour-spontaneous/induced, Bishop score at induction of labour, Side effects of drugs.

Results: Significant fall in MAP was seen in patients receiving Labetalol. Mean time required to control B.P in group A was 42.22 hours and in group B it was 36.97 hours. Mean Bishop score at induction in present study in group A was 8.27 and in group B was 9.33 with a statistically significant p<0.05. (33.33%) patients went in spontaneous labour in group A while in group B, 23 patients i.e. (48.94%) patients went in spontaneous labour.

Conclusion: The study concluded that the use of labetalol to reduce blood pressure in pregnancy induced hypertension patients is significantly effective than methyl dopa along with advantage of spontaneous onset of labour.