scholarly journals Assessment of safety and efficacy of oral nifedipine and intravenous labetalol in management of increased blood pressure in severe preeclampsia

2018 ◽  
Vol 7 (7) ◽  
pp. 2645 ◽  
Author(s):  
Sujana Thalamati ◽  
Sailaja Bandaru ◽  
Divyasree Bhumireddy
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Andhra Pradesh ◽  
Tertiary Care Hospital ◽  
Controlled Trial ◽  
Tertiary Care ◽  
Target Blood Pressure ◽  
Care Hospital ◽  
Double Blind ◽  
Safety And Efficacy

Background: Pre-eclampsia (PE) is a disorder of pregnancy characterized by the onset of high blood pressure and often a significant amount of protein in the urine. Pre-eclampsia is one of the leading causes of maternal and perinatal morbidity and mortality worldwide. The objective of the present study was to assess and compare the safety and efficacy of oral nifedipine and intravenous labetalol in the management of severe pre-eclampsia.Methods: A double-blind, randomized, controlled trial was conducted at a tertiary care hospital in Andhra Pradesh, on pregnant women presenting with a systolic blood pressure of 160 mm Hg or more or diastolic blood pressure of 110 mm Hg or more. The pregnant women were randomized to receive Oral nifedipine (10 mg tablet orally up to five doses) and intravenous labetalol injection in escalating doses until the target blood pressure of 150 mm Hg systolic and 100 mm Hg diastolic, or lower, was achieved. The primary endpoint of the study was the time taken by each agent to achieve target blood pressure. Secondary endpoints were number of doses required, adverse maternal and neonatal effects, side effect profile, and perinatal outcome.Results: The study was conducted in a tertiary care hospital in Andhra Pradesh from July 2016 to October 2017, on 100 pregnant women presenting with preeclampsia. The median time taken to achieve target blood pressure was 44 minutes (range: 20-60 minutes) for Oral Nifedipine and 68 minutes (range: 40-85 minutes) for Intravenous labetalol (P=0.008).  No serious adverse maternal or perinatal side effects were encountered in both the groups.Conclusions: Both oral nifedipine and intravenous labetalol are effective in the management of acute hypertensive emergencies of pregnancy; however, oral nifedipine effectively decreased the blood pressure rapidly compared to intravenous labetalol.

scholarly journals A randomized cross over trial of oral nifedipine and intravenous labetalol in pregnant women with severe pre-eclampsia and eclampsia

2019 ◽  
Vol 8 (3) ◽  
pp. 921
Author(s):  
Kirtan Krishna ◽  
N. Shailaja ◽  
B. Shyamasundara Bhat ◽  
L. Krishna ◽  
Namrata .
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Tertiary Care ◽  
Maternal Blood ◽  
Target Blood Pressure ◽  
Care Hospital ◽  
Rapid Control ◽  
The Mean ◽  
To Receive ◽  
Mean Time

Background: The aim of treatment of severe pre-eclampsia and eclampsia is to quickly bring about a smooth reduction in blood pressure to levels that are safe for both mother and baby but avoiding any sudden drops. There are not many studies comparing nifedipine and labetalol for this purpose. Authors conducted this study with the aim of comparing their efficacy in reducing maternal blood pressure.Methods: It was a cross over trial with 30 patients in each group conducted at a tertiary care hospital. 60 pregnant women were randomized to receive nifedipine (20mg loading dose followed by 10 mg tablet, orally, up to maximum of five doses) or  intravenous labetalol  (in an escalating dose regimen of 20, 40, 80, 80 and 80 mg)  every 20 minutes until the target blood pressure of 150/100 mmHg was achieved. Crossover treatment was affected if the initial treatment regimen was unsuccessful after 20 min of the last dose of the drug in the respective groups.Results: The mean time to achieve the target blood pressure was 32.0 ±18.64 minutes (mean ± SD) in nifedipine group as compared with 37.04 ± 16.36 minutes in those receiving labetalol (P = .002). In the nifedipine group 63.3% required only one dose compared to 36.6% in the labetalol group.  Only two women in the nifedipine group required maximum number of doses that is five doses. Cross over treatment was required by 10% of patients in the labetalol group and none in the nifedipine group.Conclusions: This study shows that oral nifedipine is more effective than intravenous labetalol in rapid control of hypertension in severe pre-eclampsia and eclampsia.

scholarly journals Asymptomatic Bacteriuria among Pregnant Women Attending Tertiary Care Hospital in Lucknow, India

2021 ◽  
pp. 1-8
Author(s):  
Naimshree Sonkar ◽  
Malay Banerjee ◽  
Suman Gupta ◽  
Absar Ahmad
Keyword(s):  
Haemoglobin Level ◽  
Pregnant Women ◽  
Antimicrobial Susceptibility ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Asymptomatic Bacteriuria ◽  
Care Hospital ◽  
Gram Positive ◽  
Gram Negative ◽  
E Coli

Introduction: Asymptomatic bacteriuria (ASB) is the presence of actively multiplying bacteria within the urinary tract with absence of any symptoms, resulting in adverse pregnancy outcomes. This research study was done in order to review prevalence, antimicrobial susceptibility profile, and factors associated with ASB occurring in female patients who are pregnant and being treated at a tertiary care hospital in Lucknow, India. Method and Materials: This is a cross-sectional study done among 216 pregnant women attending a hospital for antenatal check-ups. Clean catch midstream urine samples were collected and examined microscopically, and semi-quantitative culture was done on blood agar and MacConkey agar. Isolates were identified by colony morphology and biochemical tests, and antimicrobial susceptibility testing was done by using the Kirby-Bauer method. Results: Of the 216 pregnant women, 36 (16.7%) tested positive for ASB. The female gestational period, haemoglobin level, and BMI were significantly associated with ASB. Logistic regression also showed that higher haemoglobin level was less likely to ASB (AOR = 0.42, 95% confidence interval: 0.202–0.88, p = 0.021). The predominant and usual isolates were E. coli (n = 22, 61.1%), followed by Cons (n = 6, 16.7%), and S. aureus (3, 8.3%). All Gram-negative isolates were mostly sensitive to most of the drugs like piperacillin-tazobactam, cefepime, nitrofurantoin, and meropenem but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to ampicillin, vancomycin, linezolid, and nitrofurantoin but 100% resistant to co-trimoxazole. Conclusion: The present study shows the existence of ASB was 16.7% among women who are pregnant. Pregnancy duration, haemoglobin level, and BMI were significantly associated with ASB. The isolates identified more frequently were E. coli (61.16%), Cons (16.7%), and S. aureus (8.3%). All isolates which were Gram-negative were mostly sensitive to most of the drugs but were 100% resistant to ampicillin. Similarly, Gram-positive isolates were sensitive to most of the drugs but 100% resistant to co-trimoxazole.

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