COMPARATIVE EFFECT OF ORAL NIFEDIPINE VERSUS IV LABETALOL IN SEVERE PRE ECLAMPSIA

Abstract

Introduction: Pre-eclampsia is a pregnancy disorder involving hypertension and proteinuria after 20 weeks, affecting 2-8% of pregnancies globally. Severe cases with high blood pressure require urgent intervention to prevent complications for mother and baby. This study compared Nifedipine and Labetalol for managing severe pre-eclampsia's efficacy and safety.

Methodology: A randomized controlled trial took place at the Obstetrics & Gynecology Department, Allama Iqbal Memorial Teaching Hospital, Sialkot, from Nov 16, 2024, to May 15, 2025. 260 pregnant women (130/group) with severe pre-eclampsia (>24 weeks gestation, BP ≥160/110 mmHg) were enrolled through non-probability consecutive sampling. Group A received intravenous Labetalol starting at 20 mg, escalating up to 300 mg in 20-minute intervals until reaching target BP (<160/100 mmHg). Group B took oral Nifedipine 10 mg every 20 mins, up to 50 mg, until target BP or 2 hrs. Primary outcomes included time to target BP and success rate (<2 hrs to achieve target BP).

Results: The Oral Nifedipine group achieved target blood pressure in 30.20±3.21 minutes, significantly faster than the IV Labetalol group at 44.05±7.06 minutes (p=0.001). Nifedipine group success rate was notably higher at 87.7% compared to Labetalol group's 64.6% (p=0.001).

Conclusion: Oral Nifedipine is more effective than IV Labetalol in rapidly controlling blood pressure in severe pre-eclampsia, making it a preferred first-line agent due to its superior efficacy, ease of use, and consistent performance across patient demographics and clinical factors.