Publication:

A prospective comparative interventional study of intravenous labetalol and oral nifedipine in the management of severe preeclampsia at a tertiary care hospital

Background Severe preeclampsia is an obstetric emergency requiring prompt blood pressure control to prevent maternal and perinatal morbidity. Intravenous labetalol and oral nifedipine are both recommended first-line agents, yet comparative data from Indian tertiary care settings remain limited.

Methods A hospital-based prospective non-randomized comparative interventional study was conducted at the Department of Obstetrics and Gynecology, Government Medical College, Akola, Maharashtra. One hundred and fifty women with severe preeclampsia were allocated equally to intravenous labetalol (Group A, n=75) or oral nifedipine (Group B, n=75) per treating-unit protocol from November 2022 to October 2023. Blood pressure was recorded at baseline, 30 minutes, 1 hour, 2 hours, 6 hours and 24 hours. Maternal complications and perinatal outcomes were compared.

Results Both agents produced progressive, clinically meaningful reductions in systolic and diastolic blood pressure. Systolic blood pressure was lower in the nifedipine group at several time points, but baseline systolic pressure also differed between groups, requiring cautious interpretation. Maternal complication rates were comparable (no complication: labetalol 74.7% vs. nifedipine 72.0%; p=0.287). Birth-weight distribution was similar. Five-minute Apgar scores and NICU admission rates differed significantly in favour of nifedipine (p=0.043 each), though absolute event numbers were small.

Conclusions Intravenous labetalol and oral nifedipine were both effective first-line options for acute blood pressure control in severe preeclampsia. Oral nifedipine offers practical advantages when IV access is limited. IV labetalol remains valuable when titratable parenteral therapy is preferred. Prompt protocol-based treatment is more important than rigid preference for either drug.