Key result
Labetalol eliminates significant proteinuria vs methyldopa in uncontrolled PIH and cuts labor inductions ~24%.
Why the study?
Does labetalol improve blood pressure control and safety compared to methyldopa in primigravidas with mild to moderate pregnancy-induced hypertension?
RCT (n=104)
randomly allocated
Does labetalol improve blood pressure control and safety compared to methyldopa in primigravidas with mild to moderate pregnancy-induced hypertension?
Absolute Event Rate: 0% vs 18.5%
Labetalol provides more efficient blood pressure control, better renal protection (preventing proteinuria), and fewer side effects than methyldopa in primigravidas with pregnancy-induced hypertension.
Supports labetalol preference over methyldopa in mild-moderate PIH; extends RCT evidence for renal protection and fewer interventions.
OBJECTIVE: To assess the efficacy and safety of labetalol compared with methyldopa in the management of mild and moderate cases of pregnancy-induced hypertension (PIH). METHODS: One hundred four primigravidas with PIH were randomly allocated to receive either labetalol (group A) or methyldopa (group B). The dose of the drugs was doubled every 48 h to maintain a mean arterial blood pressure < or = 103.6 mmHg. Clinico-biochemical effects and frequency of side effects were studied. The statistical level of significance was taken at P < 0.05. RESULTS: Ten patients in group B (18.5%) developed significant proteinuria (> 30 mg/dl) whereas none developed proteinuria in group A. Labetalol was quicker and more efficient at controlling blood pressure, having a beneficial effect on renal functions and causing fewer side effects compared with methyldopa. The rate of induction of labor and rate of cesarean section for uncontrolled PIH was less in group A (48% and 1%, respectively) compared with group B (63.0% and 5.6%, respectively). Moreover a higher Bishop score at induction of labor was noticed in group A. CONCLUSIONS: Labetalol is better tolerated than methyldopa, gives more efficient control of blood pressure and may have a ripening effect on the uterine cervix.
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El‐Qarmalawi et al. (1995) conducted an RCT in mild and moderate pregnancy-induced hypertension (PIH) (n=104). Labetalol vs. Methyldopa was evaluated on Significant proteinuria (> 30 mg/dl). Labetalol prevented significant proteinuria compared to methyldopa (0% vs 18.5%) and resulted in lower rates of labor induction (48% vs 63%) and cesarean section (1% vs 5.6%) for uncontrolled PIH.