Nifedipine Versus Nitroglycerin in the Inhibition of Preterm Labour

Aim of Work: To compare the safety & efficacy of oral nifedipine with transdermal nitroglycerin in the inhibition of preterm labour. Methods: This study included 60 women in preterm labour, randomly divided into two groups, the first 30 patients received oral nifedipine and the second 30 patients used transdermal nitroglycerin (NTG). Patients in preterm labour with a single gestation, between the 26th and the 34th week and no contraindication for tocolysis were selected. Women with fetal malformation and medical or obstetric diseases were excluded. The variables analyzed were: Delay in delivery for 48 hours, 7 days or more than 7 days, period of gestation at delivery, side effect profile of drugs & neonatal outcomes. Results: Mean prolongation of pregnancy was more with NTG (30.13 ±3.0 days) compared to that of nifedipine (29.57±3.6 days). Nifedipine was more successful in prolonging pregnancy beyond 48 hours. Failure of acute tocolysis, defined as delivery within 48 hours, was more common with NTG (33.3 %) as compared to nifedipine (23.3 %). Headache was higher in the NTG group (3.3%) compared to nifedipine group (0%). The neonatal outcomes in terms of respiratory distress was higher in nifedipne (76.7%) than NTG group (63.3%). There was no statistically significant difference between both groups. Conclusions: Transdermal nitroglycerin is as safe and effective tocolytic agent compared with oral nifedipine.