Conclusions
HYPERTENSIVE EMERGENCY, REBOUND PHENOMENON, SEVERE PREECLAMPSIA
Our data suggested that nifedipine is the most effective in reducing blood pressure using a single dose administration during hypertensive emergency in severe preeclampsia. The lowering blood pressure effect of nifedipine was not significantly different to labetalol but was significantly superior as compared with hydralazine. Nifedipine had a significant rebound phenomenon in blood pressure after four hours of drug administration, hence the necessity of re-administering antihypertensives. In maintaining the low blood pressure, hydralazine was significantly more effective than labetalol and no different effectiveness between hydralazine and nifedipine. All drugs are considered safe after triple dose administration within one hour. Based on the present study, in high resource settings, hydralazine is recommended to treat severe preeclampsia cases with hypertensive emergency since it reduces the blood pressure rapidly and has no rebound phenomenon. We recommend to use nifedipine in the low resource settings since it is cheap and easy to use and store while still has good ability to reduce the blood pressure. However, blood pressure maintenance is required because it might rebound after approximately six hours.