Maternal outcomes caused by receiving magnesium sulfate to suppress preterm labor

Document Type : Original Article

Authors

1 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

2 M.Sc. of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

3 Assistant Professor, Department of Physiology, Women's Reproductive Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

4 Professor, Department of Obstetrics and Gynecology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

Introduction: Nowadays, a high percentage of pregnant women experience preterm labor. This causes a lot of problems for mother and her premature infant. Women who experience preterm labor are usually treated with a certain drug compounds to prevent uterine contractions. This study was performed aimed to compare the effects of magnesium sulfate and nifedipine on inhibition of preterm labor and maternal complications caused by administration of magnesium sulfate and nifedipine.
Methods: This Interventional control trial study was performed on 80 pregnant women referring to Tabriz medical-training centers of Taleghani and Alzahra in 2012. One group was given sulfate magnesium and simultaneously received a placebo instead of nifedipine. The other group was given Nifedipine tablet and simultaneously, serum ringer was infused as placebo. Data collection tools consisted of checklist and patrograph form. Data was analyzed using SPSS software (version 15), and t-independent, chi-square, test, and Kolmogorov-Smirnov tests. PResults: Uterine contractions and labor progress was suppressed in 35 cases (87.5%) of Nifedipine group and 19 (47.5%) of sulfate magnesium group (P=?). Maternal tachycardia was observed in 27 cases (67.5%) of Nifedipine group and dyspnea in 26 (65%) of sulfate magnesium group. After delivery, no complication was observed in Nifedipine group, but 3 cases of uterine atony and 2 cases of the placenta abruption was occurred in sulfate magnesium group (P=?). Two groups were not significantly different in terms of delivery mode (P=0.7).
Conclusion: Nifedipine is more effective than sulfate magnesium to suppress preterm labor and has less side effects. Therefore, Nifedipine can be a better alternative in the treatment of preterm labor.

Keywords


  1. Cunningham FG, Kenneth JL, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams obstetrics. 23rd ed. New York:McGraw-Hill;2010.
  2. In: Kliegman RM, Behrman RE, Jenson HB, Stanton B. Nelson textbook of pediatrics. 18th ed. Philadelphia:Saunders;2007
  3. Han S, Crowther CA, Moore V. Magnesium maintenance therapy for preventing preterm birth after threatened preterm labour. Cochrane Database Syst Rev 2010 Jul 7;(7): CD000940. doi: 10.1002/14651858.CD000940.pub2.
  4. Haas DM, Imperial TF, Kirkpatrick PR, Klein RW, Zollinger TW, Golichowski AM. Tocolytic therapy: a meta-analysis and decision analysis. Obstet Gynecol 2009 Mar;113(3):585-94.
  5. Simchen MJ, Dulitzky M, Shlomo SA, Schiff E. Adjustment of magnesium sulfate infusion rate in patients with preterm labor. Am J Obstet Gynecol 1998 Oct;179(4):994-8.
  6. Chandraharan E, Arulkumaran S. Recent advances in management of preterm labor. J Obstet Gynecol India 2005 Mar-Apr;55(2):118- 24.
  7. Caughey AB, Ahsan A, Hopkins LM, Vargas JE, Stephanie OW. Blueprints clinical cases in obstetrics and gynecology. 2nd ed. Philadelphia:Lippincott Williams & Wilkins;2006.
  8. Ricci S, Kyle T, Carman S. Maternity and pediatric nursing. 2nd ed. Philadelphia:Lippincott Williams & Wilkins;2013.
  9. Haghighi L. Prevention of preterm delivery: nifedipine or magnesium sulfate. Int J Gynecol Obstet 1999 Sep;66(3):297-8.
  10. Lotfalizadeh M, Teymoori M. [Comparison of Nifedipine and Magnesium Sulfate in the Treatment of Preterm] [Article in Persian]. Iran J obstet Gynecol Infertil 2010;13(2):7-12.
  11. Nandita M, Vincent C, Verma RN, Desai VA. Maternal and fetal cardiovascular side effects of nifedipine and ritodrine used as tocolytics. J Obstet Gynecol India 2007 Mar-Apr;57(2):131-4