Labetalol is a commonly used first-line drug for the treatment of gestational hypertension (GHT). It has rarely been associated with Raynaud’s phenomenon of the nipple (RPN). Herein, we report a case of labetalol-associated RPN, the first from India. A 30-year-old woman, gravida 1, para 0, with no significant medical history and regular antenatal check-up was diagnosed with GHT at 34 weeks of gestation. She was initiated on tablet Labetalol 100 mg twice daily. Around 1-hour after the first dose, she complained of severe burning sensation with severe tenderness at nipple-areola area, lasting 2-3 hours. She experienced similar symptoms, within 45 minutes of second dose and immediately contacted her Obstetrician. Subsequently, tablet Labetalol was withdrawn and tablet Nifedipine 20 mg twice daily was initiated, following which she did not experience any adverse events and pregnancy remained uneventfully till delivery at full-term. Spontaneous resolution of nipple-related adverse event, absence of similar event following initiation and continuation of Nifedipine, and review of literature allowed us to reach the diagnosis of labetalol-associated RPN. Through this case, we intend to report a rarely documented adverse event associated with Labetalol use in pregnancy. Moreover, Obstetricians should be made aware of Labetalol-associated RPN. When prescribing Labetalol in pregnancy, patient should be counselled regarding any nipple-related discomfort and encouraged to report on an urgent basis.
