Comparison of Administration of Magnesium Sulfate and Nifedipine in Prevention of Preterm Delivery

Document Type : Original Article

Authors

1 Assistant Professor of Obstetrics and Gynecology, Semnan University of Medical Sciences, Semnan, Iran.

2 Associate Professor of Social Medicine, Semnan University of Medical Sciences, Semnan, Iran.

3 Resident in Obstetrics & Gynecology, Semnan University of Medical Sciences, Semnan, Iran.

Abstract

Introduction: Preterm labor is one of the main problems in obstetrics and gynecology medicine. Premature newborn may have numerous physical and mental disorders. The aim of this study is to compare the effects of magnesium sulfate with Nifedipine in order to prevent the preterm labor.
 
Methods: In this clinical trial, 130 preterm labored women with gestational age of 20-37 weeks were enrolled and divided into two groups regarding their age (±3years), meantime between symptoms and treatment (±2 hours) and gestational age. The exclusion criteria were diabetes mellitus, hypertension, twin pregnancy, cigarette smoking and cervical incompetence. Magnesium sulfate was used with loading dose of 4g/IV and then maintanance of 2g/h and oral Nifedipine was applied by 20 mg as first dose and then 20 mg every six hours up to 24 hours. The duration between initiation of drugs and their therapeutic effects in subsiding the preterm labor pains were evaluated and data were analyzed by Kolmogorov-Smirnov, t and Mann-Whitney U tests and the statistical significance of 0.05 were considered for analysis.
 
Results: The difference of means of intervals between treatment and pain relief in Magnesium Sulfate (15.86±14.72 min) and Nifedipine (14.32±15.39 min) were significant (P=0.01). There were no significant difference between two groups in meantime of initiation of treatment and pregnancy termination (P=0.47).
 
Conclusion: Regarding the findings of current study, it seems that Nifedipine is more effective than magnesium sulfate in prevention of preterm labor.

Keywords

References

1. Cunningham RG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap ІІІ L, Wenstrom KD. William’s obstetrics.
22nd ed. New York: McGraw-Hill; 2005. p.857-70.
2. Chandraharan E, Arulkumaran S. Recent advances in management of preterm labor, J Obstet Gynecol India
2005;55(2):118-24.
3. Moore ML. Preterm labor and birth: what have we learned in the past two decades? J Obstet Gynecol
Neonatal Nurs 2003;32(5):638-49.
4. Scott JR, Gibbs RS, Karlan BY, Haney AF, Danforth's obstetrics & gynecology. 9th ed. Philadelphia:
Lippicott Williams & Wilkins;2003. p.173-83.
5. Carr DB, Clark AL, Kernek K, Spinnato JA. Maintenance oral nifedipine for preterm labor: a randomized
clinical trial. Am J Obstet Gynecol 1999;181(4):822-7.
6. Saade GR, Taskin O, Belfort MA, Erturan B, Moise KJ Jr. In Vitro comparison of four tocolytic agents,
alone and in combination. Obstet Gynecol 1994;84(3):374-8.
7. King JF. Tocolysis and preterm labour. Curr Opin Obstet Gynecol 2004;16(6):459-63.
8. Haghighi L. Prevention of preterm delivery: nifedipine or magnesium sulfate. Int J Gynaecol Obstet
1999;66(3):297-8.
9. King JF, Flenady VJ, Papatsonis DN, Dekker GA, Carbonne B. Calcium channel blockers for inhibiting
preterm labour. Cochrane Database Syst Rev 2002;(2):CD002255.
10. King JF, Flenady V, Papatsonis D, Dekker G, Carbonne B. Calcium channel blockers for inhibiting preterm
labour; a systematic review of the evidence and a protocol for administration of nifedipine. Aust N Z J
Obstet Gynecol 2003;43(3):192-8.
11. Zhang X, Liu M. Clinical observations on the prevention and treatment of premature labor with nifedipine.
Hua Xi Yi Ke Da Xue Xue Bao 2002;33(2):288-90 (abstract)
12. Ables AZ, Romero AM, Chauhan SP. Use of calcium channel antagonists for preterm labor.
Obstet Gynecol Clin North Am 2005;32(3):519-25.
13. Papatsonis DN, Van Geijn HP, Ader HJ, Lange FM, Bleker OP, Dekker GA. Nifedipie and ritodrine in the
management of preterm labor: a randomized clinical multicenter trial. Obstet Gynecol 1997;90(2):230-4.
14. Papatsonis DN, Kok JH, Van Geijn HP,Bleker OP, Ader HJ, Dekker GA. Neonatal effects of nifedipine
and ritodrine for preterm labor. Obstet Gynecol 2000;95(4):477-81.
15. Oei SG, Mol BW, de Kleine MJ, Brölmann HA. Nifedipine versus ritodrine for suppression of preterm
labor; a meta-analysis. Acta Obstet Gynecol Scand 1999;78(9):783-8. 
و همکاران دکتر ماندانارشیدی میبدی 
6
16. Tsatsaris V, Papatsonis D, Goffinet F, Dekker G, Carbonne B. Tocolysis with nifedipine or beta-adrenergic
agonists: a meta-analysis. Obstet Gynecol 2001;97(5 Pt 2):840-7. 

Files

Share

How to cite

Statistics