Ngày 01/8/2014, Hvtbmt chính thức chuyển công tác sang trường Đại học Tây Nguyên sau 14 năm (thiếu 1 tháng) gắn bó với BVĐK tỉnh Đắk Lắk. Nhiều cảm xúc vui - buồn lẫn lộn...

Oral nifedipine lowers blood pressure in pregnancy more rapidly than intravenous labetalol

Feb 2014 

Hypertension is common during pregnancy, but the choice of standard first-line therapy remains controversial since there are concerns over hydralazine and no clear evidence of the superiority of nifedipine or labetalol. However, a recent head-to-head comparison of the latter two agents has shown that nifedipine appears to exert a superior effect.

Between October 2012 and April 2013, researchers at a tertiary care teaching and referral hospital in India conducted a double-blind trial involving 60 women aged 18–45 years who were at 24 weeks’ gestation or greater and who had sustained severe hypertension (defined as systolic blood pressure [BP] ≥ 160 mm Hg or diastolic BP ≥ 110 mm Hg measured on two separate occasions at least 30 minutes apart). The women were randomly assigned to receive up to five doses of oral nifedipine 10 mg and an intravenous (IV) saline injection (n = 30) or up to five doses of IV labetalol 20 mg, 40 mg, or 80 mg and a placebo tablet (n = 30) every 20 minutes until the target BP of 150 mm Hg systolic and 100 mm Hg diastolic or lower was met. Labetalol was administered via three 20-mL syringes, each of which contained 5 mg/mL of the agent. A total of 4 mL was administered initially, followed by 8 mL after 20 minutes if the target BP was not met; if there was still no improvement after another 20 minutes, then 16 mL was administered. Two further 16-mL injections could be administered if needed. The crossover treatment was administered if the initial treatment failed.

The median time to achieve the target BP was 40 minutes (interquartile range [IQR], 20–60 minutes) with nifedipine compared with 60 minutes (IQR, 40–85 minutes) with labetalol (P = 0.008). Moreover, fewer nifedipine doses were required (median, 2 [IQR, 1–3] nifedipine vs 3 [IQR, 2–4.25] labetalol; P = 0.008). No serious adverse maternal or perinatal side effects were observed in either group.

Shekhar S et al. Oral nifedipine or intravenous labetalol for hyperintensive emergency in pregnancy: a randomized controlled trial. Obstet Gynecol 2013;122(5):1057–1063.

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Nguồn: http://pub.mims.com/)

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