scholarly journals Comparison between methyldopa and combination of methyldopa and nifedipine in terms of mean change in blood pressure in pregnancy induced hypertension

2021 ◽  
Vol 15 (7) ◽  
pp. 1703-1705
Author(s):  
Bilqees Akhtar Malik ◽  
Shahzad Bashir Momina ◽  
Tazeen Ashraf
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Gestational Age ◽  
Low Dose ◽  
High Dose ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
Group A ◽  
Group B ◽  
In Pregnancy

Objective: Comparison between Methyldopa and combination of Methyldopa and Nifedipine in terms of mean change in blood pressure in pregnancy induced hypertension. Material and methods: This randomized controlled trial was conducted at Department of Obstetrics and Gynecology, Combined Military Hospital Bahawalpur from February 2020 to August 2020 over the period of 6 months. Total 80 patients with pregnancy induced hypertension as per operational definition having age 20-40 years and having gestational age ≥ 20 weeks assessed on LMP were selected. Results: Mean age of the patients was 30.81 ± 5.670 years, mean age of patients of group A was 31.50 ± 5.809 years and mean age of group B was 30.13 ± 5.515 years. Mean gestational age was 30.17 ± 5.981 weeks, mean gestational age of patients of group A was 29.70 ± 6.329 weeks and mean gestational age of patients of group B was 30.65 ± 5.65 weeks. In group A, mean diastolic blood pressure was decrease from 101.2250 ± 4.97938 to 84.5000 ± 3.26599 and in group B from 107.7750 ± 7.18434 to 82.5000 ± 2.25320. Comparison of mean decrease in diastolic blood pressure between group A (High dose Methyldopa) and group B (Low dose Low dose Methyldopa with Nifedipine) was done. Mean decrease in diastolic blood pressure in group A was 16.72 ± 3.935 and in group B was 25.28 ± 6.876. Statistically significant difference of mean decrease in diastolic blood pressure between the both groups was noted with p value 0.000. Conclusion: Results of this study showed that Low dose Methyldopa with Nifedipine combination is more effective as compared to High dose Methyldopa to reduce diastolic blood pressure in pregnant women suffering from pregnancy induced hypertension. Keywords: Diastolic blood pressure, Methyldopa, Nifedipine, Pregnancy induced hypertension, Systolic blood pressure

scholarly journals COMPARISON OF INTRAVENOUS LABETALOL AND ORAL NIFEDIPINE IN MANAGEMENT OF BLOOD PRESSURE IN PATIENTS WITH SEVERE PREGNANCY INDUCED HYPERTENSION

2019 ◽  
Vol 10 (4) ◽  
pp. 26-30
Author(s):  
Tehseen Aslam ◽  
Nuzhat Parveen ◽  
Shakeela Irfan ◽  
Uzma Riaz ◽  
Amin Anjum
Keyword(s):  
Blood Pressure ◽  
Blood Pressure Control ◽  
Pressure Control ◽  
Pregnancy Induced Hypertension ◽  
Achieve Blood Pressure Control ◽  
Achieve Blood Pressure ◽  
Induced Hypertension ◽  
Group A ◽  
Group B ◽  
Mean Time

ABSTRACT:It is estimated that 6-12% of all the pregnancies are complicated by hypertension and even all improvements pre eclempsia is a significant reason of maternal and perinatal morbidity and mortality worldwide. Nifedipine, Labetalol and hydralazine are mostly being used in acute management of hypertension in pregnancy but so far there is no evidence that anyone drug is more effective. OBJECTIVE: To compare the mean time to achieve blood pressure control of oral Nifedipine with intravenous Labetalol for management of severe pregnancy induced hypertension. METHODOLOGY: This randomized control trial was done in Obstetrics and Gynaecology department of Hilal-e-Ahmer hospital, Faisalabad over a period of 6 months from 01-07-2016 to 31-12-2016. Total 100 patients (group-A and group–B having 50 in each) were included in study. In group A, females were given 40mg oral Nifedipine and in group, females were given 20ml intravenous Labetalol. Time at administration was followed in the ward for assessment of blood pressure control. Blood pressure was noted after every 10 min. The total donation time to achieve B.P was noted (as per operational definition).The collected data was analyzed by using SPSS version 17.0. Baseline blood pressure were presented in the form of mean+SD. Both groups were compared for mean time to achieve blood pressure control by applying t- test and consider significant at p value <5%.RESULTS: Patients were ranged between 20-40 years. Mean age of the patients was calculated as 26.98+4.54 and 27.36+4.43 years in group-A and B respectively. Gestational age shows that 64%(n=32) in Group-A 74%(37%) in Group–B were between 20-30 weeks of gestation while 36%(n=18) in Group-A were between 31-40 weeks of gestation mean±SD was calculated as 28.92+4.91 and 28.94+4.72 weeks in Group-A and B respectively. Mean time to achieve B.P control in group A was 31.24+5.62 and in group B 45.5+4.63 with p value <0.05. CONCLUSION: Mean time to achieve blood pressure control was shorter with oral Nifedipine when compared to I/V Labetalol for management of female presenting with severe pregnancy induced hypertension. 

Outcome of Labetalol and Methyldopa as Oral Antihypertensive Agent in the Treatment of Pregnancy Induced Hypertension

Mediscope ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. 19-26
Author(s):  
Kakali Rani Ghosh ◽  
Shamima Akhter ◽  
Adhir Kumar Das ◽  
Naznin Naher ◽  
Suma Rani Paul ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Antihypertensive Drugs ◽  
Treated Group ◽  
Mean Blood Pressure ◽  
Pregnancy Induced Hypertension ◽  
Mortality And Morbidity ◽  
Induced Hypertension ◽  
Group A ◽  
Group B

Background: In a developing country like Bangladesh pregnancy induced hypertension is an important medical problem and a major cause of maternal and perinatal mortality and morbidity. Antihypertensive drugs are often used to lower blood pressure and also help in reducing maternal and fetal complications. Objective: To compare the efficacy and safety of labetalol and methyldopa in management of pregnancy induced hypertension. Methods: A total of 100 patients having newly onset hypertension during pregnancy were taken and divided randomly into two groups. Group A was given labetalol and group B methyldopa. In both groupsmean blood pressure was measured on 1stday as pretreatment and at 48th hour and 8th day as post-treatment measurement, total dose of each drug require per day and side effects were recorded.Reduction in blood pressure, doseand side effects were compared. Results: Labetalol treated group of patients showed significant fall in mean blood pressure from 1st day to 48th hour and 1st day to 8th day.In patients treated with labetalol mean blood pressure on 1st day was 123.9 ± 17.11 mmHg and was controlled to 100.03 ± 6.38 mmHg on 48th hour and 94.13 ± 4.3 mmHg on day 8, while in methyldopa treated group on 1st day was 121.23 ± 13.597 mmHg which was reduced to 105.8 ± 6.53 mmHg on 48th hour and 97.96 ± 4.11 mmHg on day 8.The mean drug dosage required to control BP in group A was 380 ± 259.5 mg and in group B was 1540 ± 503.45 mg. Group A had less side effects. Conclusion: Labetalol is safe more efficacious and quicker control of blood pressure withless maternal adverse effects and thus advantageous over methyldopa. Mediscope Vol. 8, No. 1: January 2021, Page 19-26

scholarly journals INDUCTION OF LABOUR;

2017 ◽  
Vol 24 (04) ◽  
pp. 522-525
Author(s):  
Nadia Taj ◽  
Rahat Akhtar ◽  
Sumera Mehnaz ◽  
Aamir Furqan
Keyword(s):  
Caesarean Section ◽  
Gestational Age ◽  
Expectant Management ◽  
Induction Of Labour ◽  
P Value ◽  
Pregnancy Induced Hypertension ◽  
Induction Group ◽  
Induced Hypertension ◽  
Group A ◽  
Group B

Objectives: To compare maternal outcome in planned induction of laborversus expectant management in pregnancy induced hypertension between 36 to 40 weeks ofgestation. Study Design: Randomized controlled trial. Setting: Obstetrics and Gynecology UnitII of Nishter Hospital Multan. Period: January 2016 to July 2016. Materials and Methods: Onehundred and thirty six (136) women with diagnosis of mild pregnancy induced hypertension,having gestational age 36 to 40 weeks were selected for this study. The selected patients wereallocated randomly into two equal groups i.e. Group A (Induction group) & Group B (Expectantgroup). The primary outcomes of this study were rate of cesarean section delivery anddevelopment of severe pre-eclampsia. Independent sample t-test was used to compare agebetween the groups. Chi-square test was used to compare age groups and study endpointsbetween the groups. Results: Mean gestational age at the time of delivery was 38.3 ± 0.75weeks for group A and 39.2 ± 0.55 weeks for group B (P-value >0.05). Mode of delivery was 52(76.47%) patients by vaginal and 16 (23.53%) by caesarean section in group A. While in groupB, out of 68 deliveries, 40 (58.82%) patients delivered by vaginal and 28 (41.18%) by caesareansection (p-value <0.05). Regarding maternal outcomes, severe pre-eclampsia occurred in 05(7.35%) women of group A while in group B, it was noted 15 (22.05%) women (p-value<0.05).The final outcome was considered satisfactory in 76.47% patients in Induction group regardingvaginal delivery and severe pre-eclampsia while in Expectant group satisfactory outcomes wereachieved in only 23.53% women (p-value <0.05). Conclusion: Induction of labour is associatedwith improved maternal outcome in terms of caesarean section and pre-eclampsia in womenwith mild PIH beyond 36 weeks of gestation as compared to the expectant management.

scholarly journals Blood Pressure and Angiogenic Markers in Pregnancy

Hypertension ◽  
2020 ◽  
Vol 76 (3) ◽  
pp. 901-909 ◽  
Author(s):  
Anna Birukov ◽  
Florian Herse ◽  
Julie H. Nielsen ◽  
Henriette B. Kyhl ◽  
Michaela Golic ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Cardiovascular Health ◽  
Mean Difference ◽  
Pregnancy Induced Hypertension ◽  
Third Trimester ◽  
Induced Hypertension ◽  
Angiogenic Markers ◽  
In Pregnancy

Pregnancy-induced hypertension is a severe pregnancy complication, increasing risk of long-term cardiovascular disease in mothers and offspring. We hypothesized that maternal blood pressure in pregnancy associated with offspring blood pressure; that the associations were sex-specific; and that maternal circulating placental angiogenic markers (PlGF [placental growth factor] and sFlt-1 [soluble fms-like tyrosine kinase-1]) mediated this relationship. We analyzed data from 2434 women and 2217 children from the Odense Child Cohort, a prospective Danish cohort study. Offspring blood pressure trajectory from 4 months to 5 years was highly associated to maternal first, second, and third trimester blood pressure, and mean blood pressure in pregnancy, independent of maternal and offspring covariates. There were offspring sex-specific associations: Girls from mothers in the highest quartile of first and third trimester blood pressure had significantly higher systolic blood pressure at 5 years than the rest of the cohort (mean difference±SEM: 1.81±0.59 and 2.11±0.59 mm Hg, respectively, all P <0.01); whereas boys had significantly higher diastolic blood pressure at 5 years (mean difference±SEM: 1.11±0.45 and 1.03±0.45, respectively, all P <0.05). Concentrations of PlGF at gestational week 28 correlated inversely to maternal gestational blood pressure trajectory, independent of the diagnosis of pregnancy-induced hypertension, adjusted β coefficients (95% CI) for predicting systolic blood pressure (SBP): −3.18 (−4.66 to −1.70) mm Hg, for predicting diastolic blood pressure (DBP): −2.48 (−3.57 to −1.40) mm Hg. In conclusion, maternal gestational blood pressure predicted offspring blood pressure trajectory until 5 years in a sex-differential manner. Furthermore, subtle alterations in blood pressure in early pregnancy preceded hypertension or preeclampsia, and PlGF was a mediator of cardiovascular health in pregnancy.

scholarly journals Oral Nifedipine Versus Intravenous Labetalol in the Management of Severe Pregnancy Induced Hypertension: A Randomized Control Trial

2021 ◽  
Vol 20 (1) ◽  
pp. 55-61
Author(s):  
Farah Naz Mabud ◽  
Serajun Noor ◽  
Shahanara Chowdhury
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Mode Of Delivery ◽  
Multiple Pregnancy ◽  
Drug Dose ◽  
Time Interval ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
Group A ◽  
Group B

Background : Pregnancy-also known as gestation is the time during which one or more offspring develops inside a woman. A multiple pregnancy involves more than one offspring, such as with twins. Pregnancy usually occurs by sexual intercourse, but can occur through assisted reproductive technology protedures. To assess the efficacy of oral Nifedipine and I/V Labetalol for lowering BP in severe PIH after 28 weeks of pregnancy. Materials and methods: In this study 100 subjects were selected with severe pregnancy induced hypertension as per inclusion criteria. After taking informed written consent they were randomly allocated into two groups, A & B. Group A received initially tablet nifedipine 10 mg orally with repeated doses of 20 mg every 20 minutes upto five doses while Group B received intravenous labetalol 20 mg initially followed by escalating doses of 40, 80, 80 and 80 mg every 20 minutes until the therapeutic goal blood pressure Systolic £ 150 mmHg & diastolic £ 100 mmHg was achieved. Primary outcomes were the time interval and the number of doses needed to achieve a blood pressure of £ 150/100 mmHg, Secondary outcomes were fetomaternal safety, efficacy and side effects of both drugs. The outcomes were recorded in a preformed data collection sheet. All the data were analyzed by computer based software SPSS version 19 (SPSS Inc, Chicago, IL, USA). P <0.05 at 95% level was taken as statistically significant. Results: A total of 100 patients of different ages with mean age of 27.41 years were taken in the study. Primi patients were more in Group A the Group B and mode of delivery was commonly caesarian section (66% vs 78%) in both groups. Proportion of target BP achievement were 100% in Group A and it was 72% in Group B. Need of drug dose and time of reduction was found significantly less among Group A women. Change of mean ± SD, SBP was more rapid in Group A ( 174.90 ± 20.01 vs 158.40 ± 11.13) women who were on Group A oral nifedipine than Group B ( 179.80 ± 16.54 vs 167.40 ± 15.02) i/v labetalol group after first dose. It was same for DBP also. Need of mean dose were less in group A than Group B (1.72 vs 3.30) also total time needed to achieve target BP was less in Group A (34.40 vs 66.0 mins). There was no need of doses exceeding third dose who were on oral nifidipine than i/v labetolol. Both maternal and fetal heart rate was not influenced by both the drugs. Side effects of drugs were found more in Group B (8% vs 4%) and fetal death also more common in there (8% vs 16%). Value of APGAR scores was found higher both at 1 minute and at 5 minutes among Group A neonates than Group B. Significant urine output volume was found in Group A patients than Group B at first hour. Conclusion: Oral nifedipine and intravenous labetalol both the regimens are found to be effective in the management of severe PIH. But Nifidipine lowers blood pressure more rapidly with fewer doses with minimum fetomaternal side-effects. Chatt Maa Shi Hosp Med Coll J; Vol.20 (1); January 2021; Page 55-61

scholarly journals Pregnancy Induced Hypertension Accompanied With Anemia: Potential Stunting of Newborns

2018 ◽  
Vol 10 (6) ◽  
pp. 164 ◽  
Author(s):  
Rumelia L. Sembiring ◽  
Nasrudin Mappaware ◽  
Elizawarda . ◽  
Yusrawati Hasibuan ◽  
Andi Nilawati
Keyword(s):  
Blood Pressure ◽  
Pregnant Women ◽  
Diastolic Blood Pressure ◽  
Birth Outcomes ◽  
Anthropometric Measurements ◽  
Birth Length ◽  
Abdominal Circumference ◽  
Pregnancy Induced Hypertension ◽  
Induced Hypertension ◽  
In Pregnancy

INTRODUCTION: Pregnancy induced hypertension (PIH) of anemia pregnant women is a major contributor to adverse birth outcomes of newborns. This research aims to assess the association between pregnancy induced hypertension of anemia pregnant women and poor birth outcomes of newborns, especially body length of newborns at delivery.MATERIAL &amp; METHODS: One hundred and eight pregnant women are enrolled according to the inclusion criteria. Sociodemographic data, anthropometric measurements, obstetric profiles (gravida), and data of systolic and diastolic blood pressure were collected in this study. Trained midwives drew blood samples from pregnant women as the study samples to measure their hemoglobin (Hb) concentrations and to assess their anemia. Gestational age (GA), types of delivery, anthropometric measurements of newborns (length, weight, head circumference, abdominal circumference and chest circumference) were conducted at delivery. Univariate and bivariate linear analyses were conducted to compare birth outcomes of newborns for each groupRESULTS: Of the total 108 pregnant women as the study samples, 25 pregnant women had blood pressures at normal level and normal Hb concentrations, 36 pregnant women had pregnancy induced hypertension (PIH), 29 pregnant women had anemia and 18 pregnant women had pregnancy induced hypertension (PIH) of anemia pregnant women respectively. All groups showed significantly different characteristics of pregnant women in terms of age (p = 0,027), height (p = 0,019), weight (p = 0.000), body mass index (BMI) (p = 0,001), Hb concentration (p = 0.000), systolic blood pressure (p = 0.000), diastolic blood pressure (p = 0.000). Mean length of newborns was significantly lower in pregnancy induced hypertension (PIH) with anemia pregnant women (p = 0.001). Statistical tests showed that there were negative correlations between maternal Hb concentrations and birth length (p = 0.024) as well as blood pressure and birth length (p = 0.000).CONCLUSION: The average length of newborns in pregnancy induced hypertension (PIH) and pregnancy induced hypertension (PIH) of anemia pregnant women was statistically significant shorter length (stunting) than the normal group. Thus, it is suggested that women who give birth with these conditions should pay more attention to the intake of good nutrition in the first 5 years of their children (the gold period) to prevent long-term adverse effects.

scholarly journals COMPARISON STUDY OF IVABRADINE WITH METOPROLOL IN MANAGEMENT OF ACUTE CORONARY SYNDROME

2021 ◽  
Vol 5 (9) ◽  
Author(s):  
Rishman Tandi ◽  
Tanvi Kumar ◽  
Amritpal Singh Kahlon ◽  
Aaftab Sethi
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Acute Coronary Syndrome ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Beta Blocker ◽  
Beta Blockers ◽  
Coronary Syndrome ◽  
Group A ◽  
Group B

Introduction: Acute coronary syndrome remains as one of the most important causes for morbidity and mortality in developed countries. Therefore, evidence-based management strategy is required to offset the loss of health during an acute coronary syndrome. An effective approach includes both medical and surgical methods. This study was conducted to evaluate the medical method of management. Objective: To study blood pressure and heart rate variability after administration of Ivabradine or metoprolol in cases with acute coronary syndrome. Materials and methods: The study was a Prospective single center observational study conducted in patients attending Cardiology Intensive Care Unit in Nayyar Heart and Superspecialty Hospital, a tertiary care centre located in an urban area. All patients with Acute coronary syndrome admitted to the emergency or cardiac care unit were analysed with ECG as a preliminary diagnostic test and confirmed with troponin markers. They were either given Ivabradine or Metoprolol. Baseline evaluation and follow up was done and necessary data was collected and analysed.   Results: 100 patients were included in the study out of which 50 were given Metoprolol (Group A) and 50 were given Ivabradine (Group B). Themean age of studied cases was found to be 66.54 years in group A and 68.69 years in group B. It was observed that there was a fall in heart rate by 26.8 beats per minute with beta blocker and 24.4 beats per minute with Ivabradine. In case of blood pressure measurement, in patients with beta blocker administration, there was a fall of 25 mm Hg in systolic blood pressure and 17 mm Hg in diastolic blood pressure However, with Ivabradine there was only a fall of 8mm Hg in systolic Blood pressure and 6 mm Hg in diastolic blood pressure. Conclusion: Although Metoprolol is the drug of choice to decrease heart rate and blood pressure in acute coronary syndrome, Ivabradine is being increasingly used in cases where beta blockers are contraindicated as it has similar efficacy in lowering heart rate without compromising contractility of cardiac muscle, thereby maintaining LVEF and blood pressure. Keywords: Acute coronary syndrome, Beta Blockers, Metoprolol, Ivabradine.

scholarly journals Low Dose Bupivacaine plus Fentanyl in Subarachnoid Block for Caesarean Section

2016 ◽  
Vol 4 (1) ◽  
pp. 24-30
Author(s):  
Nasir Uddin Ahmed ◽  
Masuda Islam Khan ◽  
Aynul Islam Khan ◽  
AKM Akhtaruzzaman
Keyword(s):  
Blood Pressure ◽  
Caesarean Section ◽  
Systolic Blood Pressure ◽  
Postoperative Analgesia ◽  
Low Dose ◽  
Hyperbaric Bupivacaine ◽  
Haemodynamic Stability ◽  
Group A ◽  
Group B ◽  
Mean Time

Background: Spinal anaesthesia induced hypotension, a common problem during caesarean section, is associated with maternal nausea and vomiting and the risk of neonatal acidosis. Low dose local anaesthetic combined with opioids spinal anaesthesia better preserves maternal haemodynamic stability, resulting in equally efficacious anaesthesia.Objectives: To investigate whether this synergistic action could be used to provide effective anaesthesia while preventing hypotension during caesarean operation.Materials and method: This prospective study included 60 pregnant mothers scheduled for caesarean operation who were then divided into two groups (thirty in each). Group-A received a spinal injection of 12.5 mg of standardized 0.5% hyperbaric bupivacaine and group-B received 8 mg of 0.5% hyperbaric bupivacaine with 20 ?gm fentanyl. Hypotension was defined as the systolic blood pressure drops below 90 mm of Hg or a decrease of systolic blood pressure 25% from pre anaesthesia level and hypotension was treated with a bolus of 5 to 10 mg of intravenous ephedrine. The quality of anaesthesia and postoperative analgesia were evaluated.Results: The mean time required to reach peak sensory level was earlier in group-B than group-A and was statistically significant (p<0.05). The decrease in systolic blood pressure in group-A was significantly more than group-B (p<0.05) and vasopressor requirement was also significantly more in group-A compared to group-B (p<0.05). Mean time of two segment regression of sensory analgesia and complete sensory recovery was significantly early in group-B (p<0.05). Duration of motor recovery in group-B was significantly earlier (p<0.05). The duration of effective analgesia was significantly more in group-B (p<0.05).Conclusion: Low dose Bupivacaine with fentanyl provided excellent intraoperative sensory and motor blockade, haemodynamic stability, and effective postoperative analgesia for caesarean delivery.Delta Med Col J. Jan 2016 4(1): 24-30

Sign in / Sign up

Export Citation Format

Share Document