Ayesha Nazir, Joveria Sadaf, Saima Saleem.
Role of hydralazine in the control of blood pressure in severe pre-eclampsia and eclampsia in comparison to sublingual nifedipine.
J Surg Pak Jan ;16(2):71-4.

Objective To compare the efficacy and maternal side effects of hydralazine with sublingual nifedipine in controlling blood pressure in severe pre-eclampsia (PE) and eclampsia. Study design Quasi interventional Place & Duration of study The study was conducted in the Department of Obstetrics and Gynecology unit II, Bahawal Victoria Hospital (BVH) Bahawalpur, from January 2007 to January 2008. Methodology A total of sixty patients were divided in two groups of 30 each (group A – hydralazine and group B – nifedipine). All were admitted through emergency. Allocation to each group was random. All patients matched for variables like age, parity, previous history of PE so as to minimize the confounding effects. Results There were 20 (66.67%) patients with complications in group A and 25 (83.33%) patients in group B (p 0.136). Headache in group A was noted in 7 (35%) patients and in 10 (40%) patients of group B, palpitations reported in 6 (30%) cases of group A and 8 (32%) in group B. Maternal hypotension was found in 6 (30%) patients of group A and 7 (28%) in group B and fetal distress noted in one (5%) patient of group A only. P value in all above complications was >0.005. Hospital stay of up to 9 days was observed in 17 (56.67%) patients of group A, and four (13.33%) patients in group B. Patients who stayed 9-12 days were 12 (40%) in group A and 18 (60%) in group B, while the longest stay at hospital (12-15 days) was found in one (3.33%) patient of group A and 8 (26.67%) patients in group B. There was no patient who was admitted for more than 15 days in both the groups. When time taken to control BP was compared, one hour was observed in 15 (50%) patients in group A and 5 hours in 5 (16.67%) patients in group B after initial dose of both hydralazine and sublingual nifedipine respectively. Ten (33.33%) patients took 2-3 hours in group A and 16 (53.33%) patients in group B after 2nd dose. Total 4-5 hours time interval was observed in 5 (16.6%) patients in group A and in 9 (30%) patients of group B after receiving 4th dose. Conclusions Hydralazine was significantly more effective in controlling blood pressure (BP) after administration of its initial dose, thus reducing the total dose of drug given and had betteroutcome of mother and fetus, with reduced hospital stay as compared to sublingual nifedipine.

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