Comparative Efficacy of Labetalol and Methyldopa in the Management of Pregnancy-Induced Hypertension

Background: Pregnancy-induced hypertension (PIH) is a common obstetric complication marked by elevated blood pressure after 20 weeks of gestation, affecting 5–10% of pregnancies worldwide and contributing significantly to maternal and fetal morbidity and mortality. Effective management is crucial to prevent progression to severe conditions like preeclampsia or eclampsia. Labetalol and methyldopa are two widely used antihypertensives in pregnancy due to their safety and efficacy. Methyldopa offers a long safety record but has a slower onset and more side effects. With quicker action and better tolerability, Labetalol is increasingly preferred, though regional practices and comparative outcomes remain variable.

Aim: This study aims to evaluate the comparative efficacy of these two agents in managing PIH, with a focus on blood pressure control, and maternal side effects.

Methods: This prospective, comparative, cross-sectional study was conducted at the Department of Gynecology and Obstetrics in Dinajpur Medical College Hospital, Dinajpur, Bangladesh to assess the efficacy and safety of Methyldopa and Labetalol in 100 pregnant women with pregnancy-induced hypertension during 2 years , from January 2023 to December 2024. Participants were divided into two groups: Group A received Methyldopa (250 mg TID), and Group B received Labetalol (100 mg BID). Blood pressure, side effects, and treatment responses were monitored closely. Exclusion criteria included chronic hypertension, multiple gestation, and systemic disorders. Data were collected using structured questionnaires and analyzed using SPSS v26. Statistical significance was set at p<0.05, with t-tests and Chi-square tests applied for analysis.

Results: The study found Labetalol to be more effective and better tolerated than Methyldopa in managing pregnancy-induced hypertension. Post-treatment systolic and diastolic blood pressures were significantly lower in the Labetalol group (130.4/85.6 mmHg) compared to the Methyldopa group (136.1/89.7 mmHg). Labetalol achieved blood pressure control faster (3.6 ± 1.0 days vs. 4.8 ± 1.2 days, p = 0.0005) and required fewer additional antihypertensive agents (10% vs. 20%). Adverse effects were less familiar with Labetalol (16%) than Methyldopa (30%), with more frequent symptoms like headache and edema in the latter group, supporting Labetalol’s superior efficacy and tolerability profile.

Conclusion: Labetalol proved more effective and better tolerated than Methyldopa in managing pregnancyinduced hypertension, achieving faster blood pressure control with fewer side effects. While both drugs were effective, Labetalol’s superior efficacy and safety profile support its use as a preferred first-line antihypertensive agent by current clinical guidelines.