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EVIDENCE > The Gynuity Oral Antihypertensive Trial

Oral antihypertensive regimens for management of severe hypertension in pregnancy: a randomised trial comparing nifedipine, labetalol and methyldopa

The problem: 

-What is the best/safest oral medication to treat severely elevated blood pressure in pregnancy for mom and baby?

  • This is needed as high blood pressure in pregnancy is relatively common and dangerous; in addition, many resource-constrained settings cannot treat intravenously.

Where:

-Two hospitals in Nagpur India

What did we do:

-Evaluated 3 different oral medications for high blood pressure

  • 10mg of nifedipine – 298 pregnant women received nifedipine
  • 200mg of labetalol – 295 pregnant women received labetalol
  • 1000mg of methyldopa – 301 pregnant women received methyldopa

Who was included:

-894 pregnant women (≥28 weeks’ gestation) randomized

-These pregnant women had a systolic blood pressure ≥160mmHg or diastolic blood pressure ≥110mmHg

Outcome of interest:

-Achieving a systolic blood pressure of 120-150mmHg and a diastolic blood pressure 70-100mHg at 6 hours without an adverse outcome or fetal compromise.