EFFECT OF ORAL NIFEDIPINE OR COMBINED WITH SILDENAFIL CITRATE FOR MANAGEMENT OF THREATENED PRETERM LABOUR: RANDOMIZED TRIAL

Abstract

BACKGROUND: In developing countries, preterm birth is a leading cause of neonatal and infant illness and mortality. In southern India, there is an increase in preterm delivery and the prevalence is about 5-8 %. It is related with severe suffering for both women and babies as well as long-term disabilities; hence interventions to prevent preterm birth are critical. The threatened preterm labor can be postponed by using ―tocolytic‖ therapy in order to transfer the patient to a center with a neonatal intensive care unit or administer corticosteroids. It helps in the prevention or treatment of respiratory morbidity. AIMS: To assess the efficacy of nifedipine combined with sildenafil citrate and nifedipine alone in threatened preterm labor and also to determine the maternal and perinatal outcome. MATERIALS& METHODS: The final analysis comprised a total of 60 subjects. There were 30 people in Group A (Nifedipine) and 30 people in Group B (Sildenafil +Nifedipine). RESULTS: The mean age of the participants was identified as 21.07 ± 3.31 years and 22.87 ± 3.15 years in group A and B respectively. The cause of preterm was identified as idiopathic in the majority of the women in group A with 83.33 and in group B with 70% and 16.67%. Maternal side effects in group A were tachycardia, palpitations, nausea, and vomiting with 26.67%, 3.33%, and 16.67%, while in group B, tachycardia, facial flushing, palpitations, and headache were identified with 10%, 6.67%, 10%, 6.67%. Respiratory distress syndrome, Neonatal intensive care unit admission, perinatal death, xvii alive and healthy neonates were identified with 16.67%, 23.33%, 20%, and 53.33% in group A, whereas it was identified with 23.33%, 36.67%, 3.33%, and 56.67% respectively. The rate of success was higher with group B (93.3%) as compared in group A (50%). CONCLUSION: The combination of sildenafil citrate and nifedipine is more effective than nifedipine alone in avoiding approaching preterm labor.