Nifedipine vs. Labetalol for Managing Acute Hypertension of Pregnancy

Acute control of dangerously high blood pressure (BP) during late pregnancy is critical to good maternal and neonatal outcomes. Investigators in Malaysia conducted a randomized, double-blind trial in 50 pregnant women at ≥24 weeks' gestation with sustained, severe hypertension (defined as ≥160 mm Hg systolic or ≥110 mm Hg diastolic BP measured at least twice within 4 hours) to evaluate efficacy of oral nifedipine (10-mg tablets) versus intravenous labetalol (5 mg/mL). Initial treatments were 10-mg nifedipine plus intravenous placebo or 20-mg labetalol plus oral placebo tablet. Doses were repeated (for nifedipine [maximum cumulative total, 5 tablets]) or escalated (for labetalol [maximum individual dose, 80 mg; maximum cumulative total, 300 …