Title: A Comparative Evaluation of Nifedipine, Ritodrine & Isoxsuprine As A Tocolytic
Authors: Dr Barkha Gurjar, Dr Sony, Dr R.P.Rawat, Dr Suman Bala
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.122
Abstract
Background: Preterm birth is a leading cause of neonatal mortality & morbidity in India. The goal of tocolysis is to cause cessation of uterine contractions in preterm labour. Main objectives of this study was to compare tocolytic effect of Nifedipine, Isoxsuprine & Ritodrine .
Methods: This prospective study conducted in the Department of Obstetrics & gynaecology, J.K Lon Hospital, Kota. After taking Written and informed consent 150 cases with inclusion and exclusion criteria were selected & divided into 3 groups: A (Nifedipine), B (Ritodrine) &C (Isoxsuprine) All the patients received Injection Betamethasone. The babies were evaluated & shifted to NICU if needed.
Results: The prolongation of pregnancy upto 48 hours seen more in Nifedipine . Prolongation of pregnancy till 37 weeks was seen in 20% patients in Nifedipine, 18% in Ritodrine and 10% in Isoxsuprine.The side-effect with Nifedipine was predominantly headache(12%). Hypotension(10%) and fetal tachycardia(10%) with Ritodrine. The side effects in Isoxsuprine were Palpitation (16%) followed by hypotension(10%) and fetal tachycardia(6%) .Side effects in nifedipine group were 20%,28% in Ritodrine & 32 % in Isoxsuprine. Number of NICU admissions was 26% both in Nifedipine and Ritodrine & 40% in Isoxsuprine . Perinatal deaths were 24% in Isoxsuprine, 20% in Ritodrine and 18% in Nifedipine group.
Conclusions: In this study we conclude that oral Nifedipine is a cheaper and effective tocolytic alternative and has fewer and less serious side effects when compared with I.V Ritodrine and I.V. Isoxsuprine .
Keywords: Preterm labour , Tocolytics