2025, Number 2
Comparison between labetalol and hydralazine in the treatment of severe preeclampsia in the intensive care unit
Full text
10.35366/121722
Language: Spanish
References: 25
Page: 115-123
PDF size: 323.78 Kb.
ABSTRACT
Introduction: severe preeclampsia is a condition with an estimated prevalence of 4.6%, with high maternal and fetal morbidity and mortality. A comparison of the efficacy of labetalol versus hydralazine has been reported to be 54.5 versus 45.5% for lowering blood pressure. Material and methods: an analytical, observational, descriptive, cross-sectional study was conducted by reviewing the medical records of patients diagnosed with severe preeclampsia who were admitted to the Intensive Care Unit (ICU) of Obstetrics and Gynecology Hospital No. 3 of Centro Médico Nacional La Raza, from January 2023 to February 2024. Patients were treated with labetalol versus intravenous hydralazine. For the univariate analysis, frequencies and percentages, median and interquartile range were reported. A Mann-Whitney U test was performed to determine dependence between variables, with a p < 0.05 for statistical significance. Results: one hundred cases were analyzed (labetalol n = 25 versus hydralazine n = 75), age 32 years (19-45), gestational age 35 weeks (26-42). Comparing the groups, significant differences were observed in systolic blood pressure (SBP) on admission (188 versus 165 mmHg, p < 0.0001), diastolic blood pressure (DBP) on admission (110 versus 108 mmHg, p = 0.049), and mean arterial pressure (MAP) on admission (135 versus 125 mmHg, p < 0.0001). There were no differences in biochemical parameters on admission. The therapeutic response showed differences in the absolute systolic, diastolic and mean pressures at 20, 40 and 60 minutes from admission to therapy with hydralazine administration, but the relative decrease in SBP from admission to 20, 40 and 60 minutes (−11.34 versus −6.25%, p = 0.001, −15.28 versus −19%, p = 0.004, −20 versus −25%, p = 0.001) and in MAP from admission versus 20, 40 and 60 minutes showed differences (−11 versus −9%, p = 0.002, −19 versus −18%, p = 0.038 and −25 versus −26% p = 0.023), the decrease being deeper in labetalol at 20 and 40 minutes, and deeper for hydralazine at 60 minutes. The number of boluses required for control was lower in the labetalol group. Conclusions: there appears to be a preference for labetalol for treating patients with severe preeclampsia admitted to the ICU with higher blood pressure. Although absolute blood pressure is similar at 20, 40, and 60 minutes after admission to therapy between the groups, a decrease in blood pressure was seen with hydralazine administration. However, when analyzing the relative percentage decrease over time at 20 minutes, it was greater in the labetalol group, which coincides with the fact that fewer boluses were required to achieve blood pressure control. Adverse effects could not be accurately measured because they were not recorded prospectively or systematically.REFERENCES
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