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Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: An open-label, randomized controlled trial

The Lancet Aug 07, 2019

Easterling T, Mundle S, Bracken H, et al. - Researchers contrasted the efficiency and safety of three oral antihypertensives drugs, labetalol, nifedipine retard, and methyldopa for the management of severe hypertension in pregnancy through a multicentre, parallel-group, open-label, randomized controlled trial conducted in two public hospitals in Nagpur, India. In the study, 2,307 women were screened. Of 2,307 women, 894 women were randomized to a treatment group and were involved in the intention-to-treat analysis, ie, 298 women to the nifedipine group, 295 to the labetalol group, and 301 to the methyldopa group. In women in the nifedipine group vs the methyldopa group, the primary outcome was significantly more prevalent. Nonetheless, no variation between the nifedipine and labetalol groups or the labetalol and methyldopa groups in the primary outcome could be discovered. Seven serious adverse events were noted during the study of which one woman in the labetalol group had an intrapartum seizure and six neonates were stillborn. More than one adverse event was not observed in any birth. Therefore, in most females, every oral antihypertensive drug decreased blood pressure to the reference range. The nifedipine retard use led to a larger frequency of primary outcome achievement in comparison with labetalol or methyldopa use as single drugs. Moreover, in order to treat severe hypertension in low-resource settings, all three oral drugs—methyldopa, nifedipine, and labetalol were viable primary choices.
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