[238-POS]: Oral antihypertensive regimens for management of severe XXXX in pregnancy: Results from a pilot study in India.

@entity1 @entity591 @entity101 @entity13519
OBJECTIVES: To examine the feasibility of a randomized trial to determine whether oral regimens of nifedipine, labetalol or methyldopa are effective for acute control of severe @entity101 in pregnancy. METHODS: In an open label pilot study, 30 pregnant @entity1 in India with a sustained @entity13519    160mmHg or dBP    110mmHg were assigned sequentially to receive oral nifedipine (10mg up to 3 total doses in 6h) (n=10), oral labetalol (200mg up to 3 total doses in 6h) (n=10), or a single dose of oral methyldopa 1000mg (n=10) until the target blood pressure of 130-150mmHg systolic and 80-100mmHg diastolic was achieved. The primary endpoint of the study was achievement of the targeted blood pressure within 6h without an adverse outcome. Secondary outcomes were use of additional antihypertensives, adverse maternal and neonatal effects, and side effect profile. RESULTS: Most @entity1 achieved the target blood pressure within 6h without use of additional agents or adverse outcomes (nifedipine: 8/10; labetalol: 9/10; methyldopa: 5/10). Five in the methyldopa arm received additional medication for @entity101 ; 2 with successful control and 3 unsuccessful. One in the nifedipine arm received additional medication for @entity591 . Most @entity1 in the nifedipine arm (9/10) became tachycardic (pulse>105) at one or more monitoring visits. No serious adverse maternal or perinatal side effects occurred. CONCLUSIONS: Oral regimens of nifedipine, labetalol and methyldopa are potentially effective justifying a randomized trial of all three medications with the current dosing regimens. Findings were used to adjust operational design of the trial. DISCLOSURES: T. Easterling: None. H. Bracken: None. S. Mundle: None. L. Magee: None. P. vonDadelszen: None. B. Winikoff: None.
