Comparison of efficacy of labetalol and methyldopa in patients with pregnancy-induced hypertension

Background: In a country like India, where maternal mortality rate is still very high despite progress and development which has consistently been made in the health services, a big proportion is still deprived of it. Hypertension is the most common medical problem encountered during pregnancy. It is estimated that globally 6-8% of pregnancies are complicated by hypertension. Antihypertensive drugs are often used to lower blood pressure with the aim of preventing its progression to adverse outcomes for the mother and the fetus. The risk of developing severe hypertension is reduced to half by using antihypertensive medications. Hence, this study was planned to assess and compare efficacy of labetalol and methyldopa in controlling blood pressure in patients with PIH and to study maternal and perinatal outcome in rural Indian population.Methods: 180 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.Conclusions: The freedom from maternal and fetal side-effects, the efficient hypotensive action indicates that labetalol is suitable for use during pregnancy