Title: Role of Nifidipine in Preterm Labour - A Prospective Study
Author: Dr S .V. Nachiketha
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.111
Abstract
Background: Preterm labour and delivery remains a major cause of perinatal morbidity and mortality in the developing world. Numerous drugs and interventions have been used to prevent and inhibit the preterm labour but none have been found to be completely effective with the choice being further limited by their side effects profile. Tocolysis, the pharmacological inhibition of uterine contractions, is currently the treatment for preventing PTL.
Objectives: To assess the efficacy and pregnancy outcome of nifedipine in the treatment of preterm labour and to evaluate the maternal and fetal adverse effects associated with nifedipine.
Methods: This is a prospective randomized study, 100 antenatal cases with 28 to below 37 weeks of gestation with painful intermittent uterine contractions associated with cervical changes were considered for the study. They were given oral nifedipine and monitored for cessation of uterine contractions. Maternal and fetal side effects were also noted. The main outcomes include prolongation of pregnancy, maternal side effects and neonatal outcome.
Results: The mean prolongation of pregnancy was 30.41 days. Success rate with Nifedipine was found to be 92.8%. Significant maternal side effects such as hypotension and tachycardia were seen only in 2 patients. Facial flushing was the most common side effect observed in the study group.15% of the patients exhibited fetal tachycardia. 90% of the neonates had an apgar score of above 7 at 5 minutes with no incidence of neonatal morality or morbidity.
Conclusions: Nifedipine is a cost - effective, safe tocolytic agent with minimal adverse effects.
Keywords: Preterm labour; Tocolysis; Nifedipine.
References
1. Ulmsten U,Anderson KR, Hingerup L.Treatment of preterm labour with thecalcium antagonist nifedipine. Arch Gyanecol 1980; 229: 1-5.
2. Kedar M Ganla, Safla A Shroff, Shyam Desail, Amar G Bhinde. A prospective comparative of Nifedipine and Isoxsuprine for tocolysis. Bombay HospitalJoumal 1999; 259.
3. Kalita D, Goswami A, Muzumatar KL. A comparative study of Nifedipine and Isoxsuprine hydrochloride in the management of preterm labour. J ObstetGyanecol India 1998; 48: 47-50.
4. Rayamajhi R, Pratap K. A comparative study between Niiedipine and Isoxsuprine in the suppression of preterm labour. Kathamandu universitymedical joumal 2003;vol.1 No.2: 85-90.
5. Read M.D, Wellby DE. The use of calcium antagonist (nifedipine) to suppresspreterm labour. BJOG Sep 1986; vol 93: 933-937.
6. Murray C,Haverkamp D Albert, Orleans M, Bergia S, Pecht D. Nifedipine for treatment of preterm labour: A historic prospective study. Am J ObstetGynecol 1992; 52-56.
7. Papatsonis DN, Geijnvan HP, Ander HJ, Lange FM, Bleker OP, Decker GA. Nifedipine as a safe and effective tocolytic agent in the treatment of pretermlabour. Am J Obstet Gynecol Aug 2000; 513.
8. Kashanian M, Bahasadri S, Zolali B.Comparison of the efficacy and adverse effects of nifedipine and indomethacin for the treatment of preterm labor. International Journal of Gynecology and Obstetrics ;113 (2011) :192–195
9. Meis PJ, Ernest JM, Moore ML. Causes of low birth weight in and private patients. Am J. Obstet Gyanecol 1987; 156: 1165-1168.
10. Verma R;Gupta JK. Antibiotic treatment of bacterial vaginosis in pregnancy. Multiple meta analysis and dilemmas in interpretation, Europe J of Obst and Gyne and Reprod Bio 2006; 124:10-14.
Dr S .V. Nachiketha
Associate Professor, Department of Obg.
KIMS Hubli, Karnataka, India