Administration of 50 mg i.v. labetalol in pre-eclampsia can cause a precipitous drop in blood pressure associated with fetal death, prompting a recommendation for a lower initial dose of 5-10 mg.
Case report links IV labetalol to fetal death in preeclampsia; should not change practice and leaves optimal dosing open for study.
Labetalol (Trandate) 50 mg i.v. was administered to a pre-eclamptic primigravida with an asphytic fetus prior to cesarean section, in order to reduce the risk of excessive increase in blood pressure during induction of anesthesia. Blood pressure fell rapidly from 170/110 to 115/85 mmHg. A dead infant was born. Oral labetalol is arguably a suitable remedy for pre-eclampsia, but if i.v. administration is necessary, an initial dose of 5-10 mg is recommended.
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Olsen et al. (1992) studied this question.
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