Labetalol versus Hydralazine in the Management of Severe Pre-Eclampsia at Tertiary Hospitals in a Low-Resource Setting: A Randomised Controlled Trial

Objective: Intravenous labetalol and hydralazine are both considered first-line medications for the management of acute-onset, severe hypertension in pregnant and postpartum women. The study compared the efficacy and safety profile of intravenous labetalol and hydralazine in the control hypertension in severe pre-eclampsia. Materials and Methods: One hundred patients who presented with severe pre-eclampsia were randomized into two study groups. The fifty patients in each arm of the study received either intravenous labetalol or intravenous hydralazine for the control of blood pressure. Results: The mean age of the labetalol subjects was 28.6 ± 5.47 years while that of their hydralazine counterparts was 29.12 ± 5.77 years. The majority of respondents in both groups were primigravidae (76% vs. 78%) (P = 0.813). The number of doses of drug needed to significantly lower the mean systolic blood pressure was slightly lower in the labetalol group (2 doses) compared to the hydralazine group (5 doses) (t = 0.803Y, P = 0.977). The incidence of headaches which were the commonest complaints was comparable in both groups 8% and 10% of respondents respectively (P > 0.05). Conclusion: Although both intravenous labetalol and hydralazine are useful in patients with severe pre-eclampsia, the response to labetalol was better with comparable side effects.

Outcome of Teenage Pregnancy in a Low Resource Setting: A Comparative Study

Background: Teenage pregnancy constitutes a high-risk pregnancy due to possible physical, psychological, socio-economic and increased obstetric risks associated with it. These risks though equally present in the older pregnant women are probably less when compared with teenagers. Thus perinatal outcome of pregnancies in these groups of patients varies. Objective: To compare the socio-demographic characteristics, pattern of pregnancy complications and perinatal outcome of pregnancy among primigravid teenagers and older primigravid women. Method: A comparative study was carried out among 58 primigravid teenagers and equal numbers of adult primigravidae at Federal Teaching Hospital, Ido Ekiti, Nigeria over five year period between January 2008 and December, 2012. Their socio-demographic characteristics, booking status, pregnancy complications, estimated gestational age at delivery, mode of delivery, post-partum morbidities, neonatal birth weight and perinatal mortalities were obtained from their case notes. Results: Deliveries by teenagers accounted for 2.48% of all deliveries during the period under review. Teenage age was significantly associated with unmarried status (P < 0.001). Two-third (67.2%) of the teenagers were unbooked for antenatal care whereas less than one-quarter of the adult were unbooked. Pregnancy related complications such as, hypertensive disorders of pregnancy, cephalopelvic disproportion/obstructed labour and anaemia were more among the teenagers compared with the older women. There were also more preterm deliveries among the teenagers compared with the older women (17.2% VS 5.2%). Perinatal mortality rate was 155/1000 birth among the teenagers. The incidence of Low birth weight and perinatal mortality were significantly higher among the teenage mothers (P < 0.05). However, there was no statistical difference in the occurrence of morbidity and maternal mortality in both groups (P > 0.05). Conclusion: Pregnancy and deliveries in teenagers are high risk. Therefore, sex education as well as access to reproductive health information and care will help reduce the occurrence of unwanted pregnancies and their lasting impact on teenagers, their families, and the society.