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Saturday, November 2, 2013

Trailers (64): Oral nifedipine or IV labetalol for hypertensive emergency in pregnancy

Shekhar, et al. Oral nifedipine or intravenous labetalol for hypertensive emergency in pregnancy: a randomized controlled trial

Why should you read about this topic?

Because you want to know if there is anything better than labetalol for hypertensive emergencies in pregnancy

What were the authors trying to do?

Compare the efficacy of oral nifedipine with IV labetalol for control of blood pressure in the setting of a hypertensive emergency in pregnancy

Who participated and in what setting?

Pregnant women (N=60) in labor with a sustained systolic blood pressure >160 or diastolic blood pressure >110 at the Dr. Rajendra Prasad Government Medical College and Hospital between October 2012 to April 2013

What was the study design?

Double-masked, randomized, crossover trial comparing oral nifedipine (up to 5 doses of 10 mg/dose) with escalating doses of IV labetalol

What were the main outcome measures?

Time to achieve a blood pressure of 150/100 or lower

What were the results?

Median time to achieve the target blood pressure was shorter for nifedipine (40 minutes) than for labetalol (60 minutes)

What is the most interesting image in the paper?

Figure 3

What were the study strengths and weaknesses?

Strengths: randomized trial. Weaknesses: underpowered for maternal or fetal complications.

What does the study contribute for your practice?

Oral nifedipine is at least as good as, if not better than, IV labetalol for hypertensive emergencies in pregnancy