ROLE OF LABETALOL AND METHYLDOPA IN NEWLY DIAGNOSED MILD HYPERTENSION IN PREGNANCY: A PROSPECTIVE DRUG COMPARATIVE STUDY IN A RURAL TERTIARY CARE HOSPITAL IN INDIA

Aim: Labetalol is useful in severe hypertension (HT) in pregnancy; however, there was a need to define its role in mild HT in pregnancy. The present study was done to evaluate efficacy of labetalol in mild HT in pregnancy, compare it with that of methyldopa, and compare the tolerability of methyldopa and labetalol in patients. Methods: A prospective drug comparative study was conducted for one year in 60 mild hypertensive pregnant women, with gestational age of ≥20 weeks, receiving either labetalol or methyldopa. The primary endpoint was control of blood pressure (BP). The parameters recorded for comparison were time and dose to control BP, dose escalation, urine albumin level, adverse effects, and pregnancy outcomes. Results: Both the drugs produced significant reduction in BP in the patients (p<0.001). The patients in both groups showed significant reduction of urine albumin. Same number of patients in both groups required dose escalation. Time to control BP was less in the patients receiving methyldopa than those receiving labetalol; however, the patients receiving labetalol reported lower prevalence of adverse effects. Conclusion: Labetalol and methyldopa were found to be equally efficacious in controlling BP and had equal maternal and fetal outcomes. Methyldopa brought quicker control of BP; however, labetalol was better tolerated. This suggested that methyldopa has a better control over the blood pressure during late pregnancy, while labetalol was more efficacious in controlling it in early pregnancy. Further studies with larger sample size would be pertinent.