Nifedipine and Magnesium Sulfate: A Comparative Study for Treatment Of Preterm Labor

Abstract

Aim: A comparative study between Nifedipine and magnesium sulfate for treatment of preterm labor.

Methods: In this study 100 preterm women between 24-37 week gestations were randomly selected. In the first step all patients were hydrated by 500 ml of Ringer solutions and bed rest. Patients with gestational age lower than 34 weak took dexamethasone for fetal lung maturity. Patients were selected randomly to receive either oral nifedipine or intravenous magnesium sulfate. Nifedipine tocolysis was initiated with a 10 mg capsule which was repeated every 20 min (up to a maximal dose of 30 mg during the first hour of treatment) and then nifedipine maintenance dose was 10 mg every six hours. Tocolysis with magnesium sulfate was initiated with 10g (I.V) and then 5g (I.M) every 4 hours. In all patients, fetal heart rate, blood pressure, pulse rate, and uterine contractions were recorded.

Results: 2 patients   (4%)   after   24   hours,   5 patients (10%) after 48 hours, 4 patients (8%) after 72 hours and 26 patients (52%) after 7 days had delivery in the nifedipine group and 6 patients (12%) after 24 hours, 6 patients (6%) after 48 hours, 3patients (6%) after 72 hours and 29 patients (58%) after 7 days had delivery in the magnesium sulfate group. This characteristic was not statistically different between the two groups. In this study, 9 patients (18%) in nifedipine group and 6 patient (12%) in magnesium sulfate group had a failure treatment (contractions did not subside) and needed to take other tocolytic medications. This characteristic was also not statistically different between the two groups

Conclusion: we concluded that the oral nifedipine is a suitable alternative for magnesium sulfate with the same efficacy and side effects in the management of preterm labor.