A comparative study of efficacy and side effects of nifedipine with nifedipine along with dydrogesterone in management of preterm labor

Sapna Singh; Preeti Tyagi; Deepak Anand; Nitika Gupta; Rashmi Gupta

doi:10.18203/2320-1770.ijrcog20231534

Authors

Sapna Singh Department of Obstetrics and Gynecology, G.S.V.M. Medical College Kanpur, Uttar Pradesh, India
Preeti Tyagi Department of Obstetrics and Gynecology, G.S.V.M. Medical College Kanpur, Uttar Pradesh, India
Deepak Anand Department of Obstetrics and Gynecology, G.S.V.M. Medical College Kanpur, Uttar Pradesh, India
Nitika Gupta Department of Obstetrics and Gynecology, G.S.V.M. Medical College Kanpur, Uttar Pradesh, India
Rashmi Gupta Department of Obstetrics and Gynecology, G.S.V.M. Medical College Kanpur, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20231534

Keywords:

Dydrogesterone, Nifedipine, Preterm labor, Progesterone, Tocolytic

Abstract

Background: Preterm labor remains one of the major cause of neonatal morbidity and mortality. Different tocolytics have been studied for prolongation of pregnancy, role of progesterone in increasing latency period remains controversial. Aim of the study was to compare efficacy of nifedipine with nifedipine along with dydrogesterone as a tocolytic agent in case of preterm labor and find its impact on maternal and neonatal outcome.

Methods: This study was conducted in 100 women who presented with symptoms of preterm labor, patients were then randomized to nifedipine plus dydrogesterone therapy or nifedipine treatment. Group I received Nifedipine plus dydrogesterone 10 mg and group II received only nifedipine.

Results: There was significant difference in latency period between group I and group II polongation beyond 1 week was observed in 58% in group I and 32% in group II. There is significant difference in APGAR score at 1 minute and 5 minute between patients of group I and group II. In group I, 57.4% neonates have APGAR >7 whereas in group II 31.9% neonates have APGAR >7 at 1 minute. In Group I, 89.4 % neonates have APGAR >7 whereas in group II 68.1% neonates have APGAR >7 at 5 minutes. The mean birth weight in group I was 1.86 with SD 0.35 whereas in group II it was 1.72 with SD 0.34 which is statistically significant. However, no significant difference was found between admission in neonatal intensive care unit or neonatal complications and adverse effects between 2 groups.

Conclusions: This study found dydrogesterone along with nifedipine is more effective as tocolytic in comparison to nifedipine alone.

Metrics

Metrics Loading ...

References

Konte JM, Holbrook RH, Laros RK, Creasy RK. Short term neonatal morbidity associated with preterm birth and effect of a preterm birth prevention program on expected incidence of morbidity. Am J Perinatal. 1986;3(4):283-8.

Hack M, Berslan N, Weissman B. The effect of VLBW and social risk on neurocognitive abilities at school age. J Dev Behav Pediatrics. 1992;13(6):412-20.

Hack M, Merkatz IR, Gordon D, Jones PK, Fanaroff AA. The prognostic significance of postnatal growth in VLBW infants. Am J Obstet Gynecol 1982;143(6):693-9.

Roberts D, Brown J, Medley N, Dalziel SR. Antenatal corticosteroids for fetal lung maturation accelerating for women at risk of preterm birth. Cochrane Database Syst Rev. 2017;3:CD004454.

Crowther CA, Harding JE. Repeat doses of prenatal corticosteroids for women at risk of preterm birth for preventing neonatal respiratory disease. Cochrane Database Syst Rev. 2007;3:CD003935.

Duley LM, Draycott TJ. Tocolytic drugs for women in preterm labour. RCOG (Royal College of Obstetricians and Gynaecologists, UK) Guideline. 2002 (1B).

Anderson L, Martin W, Higgins C, Nelson S, Norman JE. The effect of progesterone on myometrial contractility, potassium channels, and tocolytic efficacy. Reprod Sci. 2009;16(11):1052–61.

Choudhary M, Suneja A, Vaid NB, Guleria K, Faridi MM. Maintenance tocolysis with oral micronized progesterone for prevention of preterm birth after arrested preterm labor. Int J Gynaecol Obstet. 2014;126(1):60-3.

Areia A, Fonseca E, Moura P. Progesterone use after successful treatment of threatened pre-term delivery. J Obstet Gynaecol. 2013;33(7):678-81.

Areeruk W, Phupong V. A randomized, double blinded, placebo controlled trial of oral dydrogesterone supplementation in the management of preterm labor. Scient Rep. 2016;6(1):1-6.

Thongchan S, Phupong V. Oral dydrogesterone as an adjunctive therapy in the management of preterm labor: a randomized, double blinded, placebo-controlled trial. BMC Pregnancy Childbirth. 2021;21(1):90.

Noblot G, Audra P, Dargent D, Faguer B, Mellier G. The use of micronized progesterone in the treatment of menace of preterm delivery. Eur J Obstet Gynecol Reprod Biol. 1991;40(3):203-9.

Borna S, Sahabi N. Progesterone for maintenance tocolytic therapy after threatened preterm labour: a randomised controlled trial. Aust N Z J Obstet Gynaecol. 2008;48(1):58-63.