Malignant ventricular arrhythmias in eclampsia: a comparison of labetalol with dihydralazine.
OBJECTIVE
Our aim was to assess the impact of beta-adrenergic blockade during the peripartum period on the previously observed high incidence of ventricular arrhythmias in eclamptic parturients.


METHODS
An open, randomized comparison of intravenous labetalol versus dihydralazine was conducted in 40 eclamptic subjects in the peripartum period. Cardiac rhythm was assessed by blinded analysis of a 24-hour Holter record by means of the Lown classification of arrhythmias.


RESULTS
There was a significantly higher incidence of serious ventricular arrhythmias in patients receiving dihydralazine (81%) than in those receiving labetalol (17%, p < 0.0001). Patients receiving labetalol showed a significant decrease in mean heart rate (p < 0.0001), whereas patients receiving dihydralazine showed a significant increase (p < 0.0001).


CONCLUSIONS
The introduction of beta-adrenergic blockade into peripartum hypertensive management of eclampsia significantly reduced the incidence of dangerous ventricular arrhythmias. Myocardial oxygen supply/demand ratio may be improved by beta-blockade.
Bhorat
I E
IE
Department of Obstetrics and Gynecology, University of Natal, Durban, South Africa.
Naidoo
D P
DP
Rout
C C
CC
Moodley
J
J
D000293:Adolescent; D000328:Adult; D004078:Dihydralazine / Q000627:therapeutic use*; D004461:Eclampsia / Q000150:complications* / Q000188:drug therapy; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D007741:Labetalol / Q000627:therapeutic use*; D011247:Pregnancy; D017180:Tachycardia, Ventricular / Q000517:prevention & control*
D004078:Dihydralazine; D007741:Labetalol