Nifedipine versus labetalol in the treatment of hypertensive disorders of pregnancy

Giannubilo SR et al. – Antihypertensive therapy in pregnancy with Labetalol may have the potential to impair fetal behavior in low degrees hypertensive diseases of pregnancy. Optimal care must balance the potentially conflicting risks and benefits to mother and fetus.
Methods

• A retrospective study in hypertensive patients treated during pregnancy with nifedipine or labetalol was conducted.
• After the charts review the patients were divided in the four groups: gestational hypertension (113 patients); mild preeclampsia (77 patients); severe preeclampsia (31 patients); HELLP syndrome (21 patients).
• The pregnancy and neonatal records were analyzed by paired and unpaired t test.

Results

• Authors found that there was an higher rate of intrauterine growth restriction infants among women treated with labetalol compared with those treated with nifedipine (38.8 vs. 15.5 %; p < 0.05), but only in the subgroup of women affected by Gestational Hypertension and Mild Preeclampsia.
• In this group was also higher the rate of fetal worsening assessed by fetal heart rate tracing (33.3 vs. 14.2 %; p < 0.05). No neonatal malformations and no differences in the rate of adverse side effects were observed. 
  

  Archives of Gynecology and Obstetrics, 05/17/2012  Clinical Article