International Journal of Reproductive BioMedicine
Research and Clinical Center for Infertility, Shahid Sadoughi University of Medical Sciences of Yazd
Vol. 17, No. 9, 2019, pp. 629-636
Bioline Code: rm19067
Full paper language: English
Document type: Research Article
Document available free of charge
International Journal of Reproductive BioMedicine, Vol. 17, No. 9, 2019, pp. 629-636
© Copyright 2019 - Bushra Ashraf
Efficacy and safety of oral nifedipine with or without vaginal progesterone in the management of threatened preterm labor|
Background: Preterm labor (PTL) is a serious emergency wherein robust management
is imperative for achieving improved outcome.
Objective: To evaluate the efficacy and safety of nifedipine alone vs nifedipine with
vaginal progesterone in managing threatened PTL.
Materials and Methods: This comparative study was carried out at the Pakistan Institute
of Medical Sciences, Islamabad over a 2-year’ period, from September, 2013 to August,
2015. The study included 276 patients with threatened PTL. Half of them were allocated
to nifedipine alone group whereas the remainder half to the additional progesterone
group. In nifedipine alone group (group A), all the patients were given 20mg of rapid
release nifedipine orally. If uterine contraction continued, a 10mg dose was repeated
every 20 min with a maximum of 40mg within the first hour. After completing the first
hour, 20mg was given every 4–6 hr for 72 hr. In the additional vaginal progesterone
group (group B), following successful tocolysis with nifedipine, additional - maintenance
tocolysis was ensured with vaginal progesterone 200mg daily.
Results: Successful acute tocolysis was achieved with nifedipine among 86.23%
patients. Mean pregnancy prolongation was 11.13 ± 5.08 days in group A while
29.73 ± 3.10 days in group B. (p≤0.001)
Conclusion: Acute tocolytic therapy with nifedipine was successful in the majority of
our patients. The additional daily use of vaginal progesterone suppositories resulted
in significant prolongation of pregnancy as well as reduction in the rate of low birth
weight and neonatal ICU admissions.
Preterm labor; Tocolytics; Nifedipine; Progesterone.
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