Comparison of Outcome of Oral Nifedipine versus Intravenous Hydralazine as Antihypertensive Therapy in the Management of Patients with Severe Preeclampsia

Shagufta Awais; Ulfat Naseem; Tahira Khalid; Afifa Akbar Ali; Zonara Qamar; Saniya Khalid

Shagufta Awais Registrar Bahria International Hospital, Rawalpindi
Ulfat Naseem Senior Registrar Ahmad medical complex, Rawalpindi
Tahira Khalid Associate Prof Federal general hospital, Chak Shehzad
Afifa Akbar Ali Registrar Holy Family Hospital Rawalpindi
Zonara Qamar Consultant Gynaecologist THQ Kotli Sattian, Rawalpindi
Saniya Khalid Consultant gynaecologist Alsuffah Hospital

Keywords: Severe Preeclampsia, Oral Nifedipine, IV Hydralazine

Abstract

Objective: To compare the outcome of oral nifedipine versus intravenous hydralazine as antihypertensive therapy for the management of severe pre-eclampsia

Methodology: This randomized controlled trial study was conducted at Obstetrics & Gynecology Department, Allama Iqbal Memorial Teaching Hospital, Sialkot from August 2020 to February 2021. Total 70(35 in each group) participants with sever preeclampsia were enrolled. All the patients were divided into Group A (oral nifedipine) or Group B (IV hydralazine). All the patients in Group-A were given oral nifedipine in the form of 10 mg tablets and every 15 minutes up to five doses or the desired blood pressure achieved. Group B patients received intravenous hydralazine injections in a dosing regimen of 5 mg IV every 15 minutes, up to a maximum of five doses or until the desired blood pressure was achieved. The clinical response to therapy for both drugs was assessed in terms of outcome. The comparison of outcomes was tested for significance using a t-test. Effect modifiers such as age, gestational age, parity, and BMI were controlled for by stratification. Post-stratification t-tests were applied, and a p-value of â‰¤ 0.05 was considered significant.

Results The mean time to achieve desired blood pressure in oral nifedipine group was 51.68Â±5.96 minutes and 39.78Â±5.15 minutes in IV hydralazine group with a p-value of 0.0001, which is statistically significant. The mean number of doses required to achieve desired blood pressure in oral nifedipine group was 5.13Â±0.72 and 3.80Â±0.43 in IV hydralazine group with a p-value of 0.00001, which is statistically significant.

Conclusion This study provides evidence supporting the use of either hydralazine or nifedipine for controlling blood pressure in acute hypertensive emergencies during pregnancy. It suggests that hydralazine may be more effective, with side effects being non-significant.