The Impact of IV Labetalol on Cardiotocographic Changes in Severe Preeclampsia.

Abstract

Objective: To evaluate the impact of intravenous (IV) labetalol on cardiotocographic (CTG) findings in patients with severe preeclampsia and to determine its association, if any, with emergency caesarean section indications.

Study design: Descriptive case series. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Lady Reading Hospital MTI, Peshawar, Pakistan, from August 2023 to January 2024.

Methodology: Seventy-six pregnant women with severe preeclampsia (BP ≥160/110 mmHg) received IV labetalol for hypertension control, with continuous CTG monitoring for foetal well-being. Labetalol dosage, number of medicines administered, time to emergency caesarean, and CTG findings were recorded. Emergency caesarean sections were performed based on obstetric indications such as non-reassuring CTG or foetal distress, not due to labetalol administration. Data were analysed using SPSS version 23, with p <0.05 considered statistically significant.

Results: Out of the 76 patients, 68.4% (n = 52) had normal CTG findings, while 31.6% (n = 24) showed abnormalities. No significant association was found between labetalol dosage and CTG outcomes (p = 0.558). The mean time to emergency caesarean section was 10.07 ± 2.74 minutes, reflecting the clinical urgency in cases with foetal compromise rather than a direct effect of labetalol.

Conclusion: While IV labetalol is already widely recommended in guidelines, this study adds value by evaluating its impact on real- time foetal monitoring through CTG in a local clinical context. IV labetalol effectively controls blood pressure in severe preeclampsia without significantly affecting CTG findings, supporting its safety in managing maternal hypertension and foetal outcomes.

Key words: Preeclampsia, Hypertension, Labetalol, Cardiotocography, Foetal monitoring.