Evaluation of intravenous infusion of labetalol versus magnesium sulfate on cerebral hemodynamics of preeclampsia patients with severe features using transcranial doppler.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 37074522 · doi:10.1007/s10877-023-01006-4
What was done
Sixty singleton pregnant women with late-onset preeclampsia with severe features were randomized equally into two groups receiving either intravenous magnesium sulfate (Group M) or intravenous labetalol (Group L). Transcranial Doppler ultrasound of the middle cerebral artery was used to measure pulsatility index (PI), flow velocities, and estimated cerebral perfusion pressure (CPP) at baseline, 1 hour, and 6 hours post-treatment. Seizures and adverse effects were also monitored.
What was found
In the magnesium sulfate group, PI decreased from 0.77 ± 0.04 at baseline to 0.66 ± 0.05 at 1 hour and 0.66 ± 0.05 at 6 hours (p < 0.001), while CPP decreased from 103.3 ± 12.7 mmHg to 87.8 ± 10.6 mmHg at 1 hour and 89.8 ± 10.9 mmHg at 6 hours (p < 0.001). In the labetalol group, PI decreased from 0.77 ± 0.05 at baseline to 0.67 ± 0.05 at 1 hour and 0.67 ± 0.06 at 6 hours (p < 0.001), while CPP decreased from 103.6 ± 12.6 mmHg to 86.2 ± 13.02 mmHg at 1 hour and 83.7 ± 14.6 mmHg at 6 hours (p < 0.001). Blood pressure and heart rate reductions were significantly greater in the labetalol group.
Why it matters
Both magnesium sulfate and labetalol reduce cerebral perfusion pressure and vascular resistance while maintaining cerebral blood flow, supporting their hemodynamic safety in severe preeclampsia management.
Limits
The study had a small sample size (n = 60) and included only late-onset severe preeclampsia in singleton pregnancies. Specific seizure occurrences, adverse event counts, and exact numerical changes for blood pressure and heart rate were not reported in the abstract.
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