ABSTRACT
Severe hypertension in pre-eclampsia remains a leading cause of maternal and perinatal morbidity
and mortality worldwide, particularly in low-resource settings where access to timely and effective
treatment can be challenging. Rapid blood pressure control is essential to prevent complications,
and intravenous Labetalol, a combined alpha- and beta-adrenergic blocker, is widely recommended
for emergency management in pregnancy. However, there is limited evidence on its efficacy and
safety among populations in sub-Saharan Africa. This prospective cohort study was conducted at
a tertiary hospital in Nigeria to evaluate the effectiveness and tolerability of intravenous Labetalol
in women with pre-eclampsia complicated by severe hypertension, defined as systolic blood
pressure of 160 mmHg or higher and/or diastolic blood pressure of 110 mmHg or higher, beyond
28 weeks of gestation. A total of 38 women received escalating bolus doses of intravenous
Labetalol ranging from 20 mg up to a maximum cumulative dose of 300 mg until target blood
pressure levels (130–150 mmHg systolic and 80–100 mmHg diastolic) were achieved. The study
found that 84.2% of participants attained adequate blood pressure control, with a median time to
control of 20 minutes and a median of 2 doses required. Notably, 31.6% of women achieved control
with a single dose. No episodes of hypotension were recorded, though some participants
experienced mild adverse effects including maternal tachycardia (7.9%) and dizziness (13.2%).
Neonatal bradycardia was observed in 10.5% of cases, but there were no early neonatal deaths.
These findings suggest that intravenous Labetalol is both effective and well-tolerated for acute
management of severe hypertension in pre-eclamptic women in this setting. Given the potential
for neonatal bradycardia, close monitoring of newborns is recommended. This study supports the
continued use of intravenous Labetalol as a first-line treatment for severe hypertension in pre
eclampsia within resource-limited tertiary maternity care facilities.
Keywords: Pre-eclampsia, Severe hypertension, Labetalol, Antihypertensive therapy, Maternal
safety, Neonatal outcomes, Nigeria
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