Oral nifedipine therapy in the management of severe preeclampsia.

OBJECTIVE: The purpose of this study was to compare the efficacy of nifedipine (Cordipin) and hydralazine in lowering blood pressure in severe preeclampsia.

METHOD: A randomized, prospective study of 104 patients with severe preeclampsia in the Department of Obstetrics and Gynecology, Korle-Bu Teaching Hospital, Accra, Ghana, was conducted between January 1992 and June 1994.

RESULTS: Of the 104 patients recruited into the study, six did not deliver at our hospital and were thus excluded from the study. Nifedipine and hydralazine as first-line drugs controlled the blood pressure in 44 and 35 patients, respectively, but failed in 5 and 14, respectively. This was statistically significant (P < 0.05). The mean birth weight was higher in the nifedipine group (2500+/-800 g vs. 2400+/-800 g). There were 11 admissions to the neonatal intensive care unit in the nifedipine group and 13 in the hydralazine group but the difference was not statistically significant.

CONCLUSION: Nifedipine and hydralazine could both be used effectively to control blood pressure in severe preeclampsia in our subregion. While hydralazine is administered intravenously and needs strict monitoring, nifedipine is more effective, is easy to administer orally, less demanding on hospital staff, convenient and more predictable.