Key result
Nebivolol linked to ~67% lower risk of labor-related blood loss vs. standard beta-blockers.
Why the study?
Arterial hypertension in pregnant women can cause complications during childbirth and perinatal outcomes, but the advantages and disadvantages of various antihypertensive regimens during labor are not well defined.
Does nebivolol improve blood pressure control and labor outcomes in pregnant women with arterial hypertension compared to other antihypertensive regimens or no treatment?
Observational (n=228)
No
Does nebivolol improve blood pressure control and labor outcomes in pregnant women with arterial hypertension compared to other antihypertensive regimens or no treatment?
Nebivolol may offer advantages in controlling blood pressure and reducing labor complications in pregnant women with chronic arterial hypertension.
Answers are grounded in this paper and cite their sources.
May support nebivolol in hypertensive labor; hypothesis-generating from Level 3 data and requires RCTs before practice change.
Arterial hypertension can significantly impair the health of a pregnant woman and often causes complications in childbirth and perinatal complications.The purpose of the study: to identify the advantages and disadvantages of various antihypertensive regimens in women with hypertension during the labor process and their effect on the course of labor and perinatal outcomes.Material and methods. For the period 2013–2018, there were surveyed 228 women who were in labor in the Ternopil perinatal center "Mother and Child". Arterial hypertension was verified in 172 women, 56 women were healthy and formed a control group. The study included delivery time of 40 ± 2 weeks of gestation. According to the treatment program, the women in labor were divided into 4 groups: the first group — 58 women who neglected the treatment of arterial hypertension before pregnancy, and during pregnancy there was insufficient compliance; The second group — 57 women in labor with arterial hypertension, who were provided with dopegit and classic beta-blockers, (metoprolol, bisoprolol) during pregnancy; The third group — 57 women in labor who received highly selective beta-blocker with vasodilating effect nebivolol for treatment of hypertension; The fourth group — 56 healthy women in labor without hypertension and/or other somatic pathology.Results. The recommended program of treatment for arterial hypertension (with nebivolol hydrochloride) proves the sufficient control of blood pressure and avoiding of high blood pressure spikes or an excessive increase of systolic, diastolic blood pressure, and heart rate during childbirth, which could endanger the mother's health. Conclusions. The therapy with nebivolol hydrochloride for laboring women with chronic arterial hypertension allows normalizing the course and duration of childbirth, to reduce the percentage of such complications as a prolonged labor or unsatisfactory progress of labor, and to reduce the level of blood loss during childbirth.
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Humenna et al. (2018) conducted an observational in Arterial hypertension during pregnancy and labor (n=228). Nebivolol hydrochloride (with methyldopa) vs. Classic beta-blockers (metoprolol, bisoprolol) or insufficient treatment was evaluated on Blood loss ≥ 500 ml during labor. In women with arterial hypertension, an antihypertensive regimen including nebivolol hydrochloride provided better blood pressure control during labor and reduced the incidence of blood loss ≥500 ml to 8.8%, compared to 26.3% with classic beta-blockers.
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