Efficacy and safety of labetalol vs. Hydralazine in pregnant women with severe hypertension

Objective: The study aims to evaluate the effectiveness of labetalol versus hydralazine in managing severe hypertension during pregnancy. Methodology: A quasi-experimental study was conducted in the unit of the Department of Gynecology, Services Hospital Lahore, from July 30, 2021, to November 30, 2022. Recruitment of 320 pregnant women diagnosed with severe hypertension were allocated into two treatment groups. Group-A (n=160) received IV labetalol in incremental doses up to 80 mg at 20 minutes interval with maximum cumulative dose of 300 mg, and Group-B (n=160) was administered IV hydralazine in 5mg dose over five minutes, repeated at 20 minutes interval with maximum of five doses. Blood pressure and pulse were monitored every 10 minutes, with follow-up lasting for one hour. Efficacy was defined as achieving target BP ≤140/100 mmHg. Data was analyzed using SPSS version 23. Results: The target BP was achieved in 248 (77.50%) women, with 134 (83.8%) in the labetalol Group-And 114 (71.2%) in the hydralazine group (p=0.007). Hydralazine achieved BP control faster (50.25 ± 20.43 min vs. 75.34 ± 35.67 min, p=0.001), with fewer doses required (1.85 ± 0.92 vs. 3.68 ± 1.45, p=0.0001). Conclusion: Labetalol showed better overall efficacy, while hydralazine provided faster BP control with higher adverse effects. Labetalol is recommended for sustained BP management, and hydralazine for rapid BP reduction.