Comparison between Effects of Intravenous Labetalol and Hydralazine on Control of Hypertension and Maternal and Neonatal Outcomes in Severe Preeclamptic Patients: A Randomized Clinical Trial

Severe preeclampsia and eclampsia are responsible for 25% of maternal mortality, especially in developing countries. Considering the importance of this complication, the present study aimed to compare between effects of labetalol and hydralazine on control of hypertension and the maternal and neonatal outcomes in severe preeclamptic patients.

This clinical trial study was conducted on 190 severe preeclamptic patients classified into two groups (95 subjects in each group). Two groups were randomly received hydralazine (5 mg intravenously,, every 20 minutes, up to a maximum of five doses) or labetalol (at first 20 mg intravenously, and if not effective, 40, 80, 80, 80 mg respectively, every 20 minutes, up to a maximum of five doses). In both groups, blood pressure and heart rate were recorded 20 minutes after drug administration. Blood pressure control, as well as the maternal and neonatal outcomes, compared between two groups. Maternal and neonatal outcomes were compared using chi-square, Fisher's exact, Mann-Whitney, and t tests. All significant differences were at p<0.05.

Demographic characteristics and blood pressure control were similar in both groups, only five women in the hydralazine group and four women in labetalol group had persistent severe hypertension after maximum of five doses. Hypotension was not observed in both groups. Maternal tachycardia was similar in two groups. Others maternal and neonatal outcomes had no significant differences between two groups.

According to the results of this study, the effect of labetalol and hydralazin is similar in the control of hypertension in severe preeclamptic patients and there isn’t significant different in maternal and neonatal outcome in two groups.