Role of intravenous labetalol in the treatment of severe pre eclampsia and eclampsia

Abstract

Background: Hypertensive disorder of pregnancy complicates about 5-10% of all pregnancies. Severe
preeclampsia and eclampsia are the severe forms of hypertension leading to multisystem dysfunction. Early
identification of the disease and prevention of complications helps in improved maternal and fetal outcome.
Labetalol is a potential drug used in the treatment of acute hypertension. It is used in treating preeclampsia
to prevent eclampsia. Hence we would like to study the safety and efficacy of intermittent intravenous
Labetalol in the control of severe hypertension in pregnancy and its effect on fetomaternal outcome.
Materials and Methods: This cross sectional study was done in the Department of Obstetrics and
Gynaecology, Gandhi Medical College from December 2010 to September 2012. A total of 100 patients
diagnosed as severe preeclampsia and eclampsia are included in the study. Primigravida and multigravida
with severe preeclampsia, eclampsia, gestational age >20 weeks and postpartum eclampsia were included
in the study. All the patients who met inclusion criteria were given intravenous labetalol of 20mg and
repeated the dose if the blood pressure still found to be high after 15 minutes. Monitoring continued till
target blood pressure achieved till termination of pregnancy.
Results: In my study 79% of women had severe preeclampsia and 21% had eclampsia. The study showed
59% of women were primigravida and majority were of young age. 80% of women showed very high
blood pressure recordings between 160/110 - 180/110 mmHg. Only 3.8% of women with blood pressure >
160/110 mmHg were given MgSO4 after giving intravenous labetalol due to presence of imminent signs.
74% of women showed Grade I fundal changes and 5% had retinal detachment. Among the severe pre
eclamptic women, the mean difference of reduction in the systolic and diastolic blood pressure after ten
minutes of giving intravenous labetalol was highly significant (p < 0.001). Following intravenous Labetalol
only 1.2% developed eclampsia.
Conclusion: Labetalol has improved efficacy to MgSO4 with lack for intensive monitoring of blood
magnesium levels and suitability for use by primary health care personnel. The study proves it is devoid of
maternal and foetal side effects with good perinatal outcome.