Efficacy and Perinatal Outcomes of Transdermal Nitroglycerin versus Intravenous Labetalol in the Management of Severe Acute Hypertension in Pregnancy

International Journal of Medicine and Medical Sciences | Vol. 15, No. 11, November 2025 | pp. 81–88

DOI: 10.46882/2025/IJMMS/150081

Original Research Article

Efficacy and Perinatal Outcomes of Transdermal Nitroglycerin versus Intravenous Labetalol in the Management of Severe Acute Hypertension in Pregnancy

Fatima Z. Bello¹, Kwaku A. Mensah², Grace N. Ojo¹*

¹Department of Obstetrics and Gynaecology, Faculty of Clinical Sciences, Bayero University, Kano, Nigeria.

²Department of Community Health, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Abstract:

Acute hypertensive crises during the third trimester require rapid, safe therapeutic lowering of blood pressure to avoid maternal cerebrovascular injuries and minimize placental hypoperfusion. This randomized, open-label, comparative clinical trial evaluated the therapeutic efficacy, safety, and perinatal outcomes of transdermal nitroglycerin patches versus standard intravenous labetalol infusions in the acute management of severe pregnancy-induced hypertension. A total of 140 third-trimester pregnant women with a sustained blood pressure ≥ 160/110 mmHg were randomly assigned to receive either a transdermal nitroglycerin patch (5 mg/24 hours, n = 70) or intravenous labetalol (20 mg initial bolus, followed by escalated doses up to 300 mg, n = 70). The primary outcomes were the time required to achieve target blood pressure stabilization (≤ 140/90 mmHg) and the incidence of maternal or fetal adverse effects. Both therapeutic interventions effectively lowered blood pressure; however, the mean time to achieve target stabilization was significantly shorter in the intravenous labetalol group (34.2 ± 5.8 minutes) compared to the transdermal nitroglycerin group (48.5 ± 8.2 minutes, p < 0.01). Maternal adverse events, specifically severe persistent headaches, were significantly more frequent in the nitroglycerin arm (31.4% vs. 8.6%, p < 0.001). Conversely, the incidence of neonatal bradycardia and low Apgar scores at 1 minute did not show statistically significant differences between the two groups (p > 0.05). Intravenous labetalol offers more rapid blood pressure control with fewer maternal side effects than transdermal nitroglycerin in managing severe acute obstetric hypertension.

Keywords: Pregnancy-Induced Hypertension, Severe Pre-eclampsia, Labetalol, Nitroglycerin, Antihypertensive Therapy, Perinatal Outcomes

Manuscript Timeline: Received: August 14, 2025; Revised: September 22, 2025; Accepted: October 12, 2025; Published: November 13, 2025.

Citation: Bello FZ, Mensah KA, Ojo GN. Efficacy and Perinatal Outcomes of Transdermal Nitroglycerin versus Intravenous Labetalol in the Management of Severe Acute Hypertension in Pregnancy. International Journal of Medicine and Medical Sciences, 2025, 15(11): 81–88. DOI: 10.46882/2025/IJMMS/150081

Subscribe to read the full article: https://internationalscholarsjournals.org/subscribe-to-read