Evaluation of the Comparative Effectiveness of Labetolol andMethyldopa in the Treatment of Pregnancy Induced Hypertension

Umber Imtiaz Khan; Syeda Uzma; Zubaida Shaheen; Sadia Ghaffar; Faria Mumtaz; Javaria Nosheen

doi:10.70302/jpsim.v6i1.2509

Original Research

Evaluation of the Comparative Effectiveness of Labetolol andMethyldopa in the Treatment of Pregnancy Induced Hypertension

Umber Imtiaz Khan¹

Combined Military Hospital Rahim Yar Khan

Syeda Uzma²

Combined Military Hospital Bahawalpur

Zubaida Shaheen³

Combined Military Hospital Chunian

Sadia Ghaffar⁴

Combined Military Hospital Attock

Faria Mumtaz⁵

Combined Military Hospital Kohat

Javaria Nosheen⁶

Combined Military Hospital Sialkot

✉ Correspondence: Umber Imtiaz Khan Email: umber_khan2008@yahoo.com

DOI https://doi.org/10.70302/jpsim.v6i1.2509

Volume: 6, Issue 1 Pages: 42–46 Published: 10 Mar 2025

Received: 27 Jan 2024 Revised: 28 Jan 2025 Accepted: 22 Feb 2025 Published Online: 10 Mar 2025

Abstract

Objective

To compare effectiveness of labetolol and methyldopa in the treatment of pregnancy induced hypertension.

Methods

This randomized controlled trial was carried out in the Obstetrics & Gynaecology Department at a Tertiary Care Hospital in Rahim Yar Khan from September 2022 to March 2023. The study involved a total of 84 patients, with 42 patients in each group (Labetalol and Methyldopa). Inclusion criteria encompassed patients aged 20 to 40 years, with gestational age ≥ 20 weeks, and diagnosed with Pregnancy induced hypertension (PIH). The study aimed to compare the effectiveness of Labetalol and Methyldopa in treating PIH.

Results

The mean age for the Labetalol group is 29.48 with a standard deviation (SD) of 6.500, while the Methyldopa group has a mean age of 31.55 with an SD of 5.844. The mean gestational age for the Labetalol group is 28.38 weeks with an SD of 4.732, and for the Methyldopa group, it is 29.64 weeks with an SD of 4.509. In the Labetalol group, 38 out of 42 patients (90.5%) experienced efficacy, compared to 30 out of 42 (71.4%) in the Methyldopa group. The P-value of 0.049 suggests that the difference in efficacy between the both study groups is statistically significant, favouring Labetalol as the more effective treatment for pregnancy-induced hypertension.

Conclusion

Our study strongly suggests that Labetalol is more effective than Methyldopa in treating pregnancy-induced hypertension, particularly in older age groups. Future research is needed to explore side-effect profiles for a comprehensive understanding.

Keywords

PIH efficacy labetalol methyldopa.

How to Cite This Article

Khan UI, Uzma S, Shaheen Z, Ghaffar S, Mumtaz F, Nosheen J. Evaluation of the Comparative Effectiveness of Labetolol andMethyldopa in the Treatment of Pregnancy Induced Hypertension. J Pak Soc Intern Med. 2025;6(1):42–46. doi:10.70302/jpsim.v6i1.2509

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

Gudeta TA, Regassa TM. Pregnancy induced hypertension and associated factors among women attending delivery service at mizan-tepi university teaching hospital, tepi general hospital and gebretsadik shawo hospital, southwest, Ethiopia. Ethiop J Health Sci. 2019;29(1):831-40.
Aghajanian P, Ainbinder S, Akhter M, Andrew DE, Anti DR, Archie C. Current diagnosis and treatment obstetrics & gynecology. Mc Graw-Hill Companies. 2007;10:925-1281.
Von Dadelszen P, Magee LA. Preventing deaths due to the hypertensive disorders of pregnancy. Best Practice Res Clin Obstet Gynaecol. 2016;36(10):83-102
Creanga AA, Syverson C, Seed K, Callaghan WM. Pregnancy-related mortality in the United States, 2011–2013. Obstet Gynecol. 2017;130(2):366.
Garovic VD, Dechend R, Easterling T, Karumanchi SA, McMurtry Baird S, Magee LA, et al. Hypertension in pregnancy: diagnosis, blood pressure goals, and pharmacotherapy: a scientific statement from the American Heart Association. Hypertension. 2022;79(2):e21-41.
Malha L, August P. Safety of antihypertensive medications in pregnancy: Living with uncertainty. J Am Heart Assoc. 2019;8(15):e013495
Braunthal S, Brateanu A. Hypertension in pregnancy: Pathophysiology and treatment. SAGE Open Med. 2019; https://doi.org/10.1177/2050312119843700 doi:10.1177/2050312119843700
van de Vusse D, Mian P, Schoenmakers S, Flint RB, Visser W, Allegaert K. Pharmacokinetics of the most commonly used antihypertensive drugs throughout pregnancy methyldopa, labetalol, and nifedipine: a systematic review. Eur J Clin Pharmacol. 2022;78(11):1763-76.
Ehikioya E, Okobi OE, Beeko MA, Abanga R, Abah NN, Briggs L, et al. Comparing Intravenous Labetalol and Intravenous Hydralazine for Managing Severe Gestational Hypertension. Cureus. 2023;15(7):e42332.
Hoeltzenbein M, Beck E, Fietz AK, Wernicke J, Zinke S, Kayser A, et al. Pregnancy outcome after first trimester use of methyldopa: a prospective cohort study. Hypertension. 2017 ;70(1):201-8.
Easterling T, Mundle S, Bracken H, Parvekar S, Mool S, Magee LA, et al. Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial. Lancet. 2019;394(10203):1011-21.
Rauf H, Zubair F, Shaheen S, Laique T. Oral Labetalol Versus Oral Methyldopa for the Management Pregnancy Induced Hypertension. Pak J Med Health Sci. 2021;15(4):793-5.
Qasim A, Siddiqui MH, us Salam J, Nusrat U. Labetalol versus Methyldopa: efficacy in pregnancy induced hypertension. Gomal J Med Sci. 2014;12(4):233-6.
Molvi SN, Mir S, Rana VS, Jabeen F, Malik AR. Role of antihypertensive therapy in mild to moderate pregnancy-induced hypertension: a prospective randomized study comparing labetalol with alpha methyldopa. Archives of gynecology and obstetrics. 2012;285(1):1553-62.
Verma RE, Lahon KI, Tonpay SD, Kale VJ, Jain DK. A comparative randomised controlled parallel group study of efficacy and tolerability of labetalol versus methyldopa in the treatment of new onset hypertension during pregnancy. Int J Life Sci Pharma Res. 2012;2(1):23-31.
Lomte D. An open label, prospective, single center study to evaluate the efficacy of methyldopa & labetalol in treatment of patients with pregnancy-induced hypertension. JMSCR. 2015;3(10):8113-8.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2025 Journal of Pakistan Society of Internal Medicine.

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[1] Gudeta TA, Regassa TM. Pregnancy induced hypertension and associated factors among women attending delivery service at mizan-tepi university teaching hospital, tepi general hospital and gebretsadik shawo hospital, southwest, Ethiopia. Ethiop J Health Sci. 2019;29(1):831-40.

[2] Aghajanian P, Ainbinder S, Akhter M, Andrew DE, Anti DR, Archie C. Current diagnosis and treatment obstetrics & gynecology. Mc Graw-Hill Companies. 2007;10:925-1281.

[3] Von Dadelszen P, Magee LA. Preventing deaths due to the hypertensive disorders of pregnancy. Best Practice Res Clin Obstet Gynaecol. 2016;36(10):83-102

[4] Creanga AA, Syverson C, Seed K, Callaghan WM. Pregnancy-related mortality in the United States, 2011–2013. Obstet Gynecol. 2017;130(2):366.

[5] Garovic VD, Dechend R, Easterling T, Karumanchi SA, McMurtry Baird S, Magee LA, et al. Hypertension in pregnancy: diagnosis, blood pressure goals, and pharmacotherapy: a scientific statement from the American Heart Association. Hypertension. 2022;79(2):e21-41.

[6] Malha L, August P. Safety of antihypertensive medications in pregnancy: Living with uncertainty. J Am Heart Assoc. 2019;8(15):e013495

[7] Braunthal S, Brateanu A. Hypertension in pregnancy: Pathophysiology and treatment. SAGE Open Med. 2019; https://doi.org/10.1177/2050312119843700 doi:10.1177/2050312119843700

[8] van de Vusse D, Mian P, Schoenmakers S, Flint RB, Visser W, Allegaert K. Pharmacokinetics of the most commonly used antihypertensive drugs throughout pregnancy methyldopa, labetalol, and nifedipine: a systematic review. Eur J Clin Pharmacol. 2022;78(11):1763-76.

[9] Ehikioya E, Okobi OE, Beeko MA, Abanga R, Abah NN, Briggs L, et al. Comparing Intravenous Labetalol and Intravenous Hydralazine for Managing Severe Gestational Hypertension. Cureus. 2023;15(7):e42332.

[10] Hoeltzenbein M, Beck E, Fietz AK, Wernicke J, Zinke S, Kayser A, et al. Pregnancy outcome after first trimester use of methyldopa: a prospective cohort study. Hypertension. 2017 ;70(1):201-8.

[11] Easterling T, Mundle S, Bracken H, Parvekar S, Mool S, Magee LA, et al. Oral antihypertensive regimens (nifedipine retard, labetalol, and methyldopa) for management of severe hypertension in pregnancy: an open-label, randomised controlled trial. Lancet. 2019;394(10203):1011-21.

[12] Rauf H, Zubair F, Shaheen S, Laique T. Oral Labetalol Versus Oral Methyldopa for the Management Pregnancy Induced Hypertension. Pak J Med Health Sci. 2021;15(4):793-5.

[13] Qasim A, Siddiqui MH, us Salam J, Nusrat U. Labetalol versus Methyldopa: efficacy in pregnancy induced hypertension. Gomal J Med Sci. 2014;12(4):233-6.

[14] Molvi SN, Mir S, Rana VS, Jabeen F, Malik AR. Role of antihypertensive therapy in mild to moderate pregnancy-induced hypertension: a prospective randomized study comparing labetalol with alpha methyldopa. Archives of gynecology and obstetrics. 2012;285(1):1553-62.

[15] Verma RE, Lahon KI, Tonpay SD, Kale VJ, Jain DK. A comparative randomised controlled parallel group study of efficacy and tolerability of labetalol versus methyldopa in the treatment of new onset hypertension during pregnancy. Int J Life Sci Pharma Res. 2012;2(1):23-31.

[16] Lomte D. An open label, prospective, single center study to evaluate the efficacy of methyldopa & labetalol in treatment of patients with pregnancy-induced hypertension. JMSCR. 2015;3(10):8113-8.