Comparative Study between Nifedipine Alone Versus Nifedipine Combined with Sildenafil Citrate for Cases with Threatened Preterm Labour

El-Aziz, Reda Hamed Abd; Aboelwan, Youssef; Salam, Walid Abdallah Abdel; Hamed, Bassem Mohamed

doi:10.21608/zumj.2020.38771.1918

Cited by 2 publications

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“…Increased cGMP levels promote muscle relaxation by reducing intracellular calcium levels. El-Aziz et al found sildenafil and nifedipine combination superior to nifedipine in PTL and are associated with a reduction in NICU admission, improved birth weight, and fewer neonatal complications [ 12 ]. Another study found sildenafil citrate and nifedipine combination a better option for tocolytic therapy of threatened PTL [ 13 ].…”

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confidence: 99%

A Comparison of Nifedipine Versus a Combination of Nifedipine and Sildenafil Citrate in the Management of Preterm Labour

Hassan,

Waseem,

AlDardeir

et al. 2023

Cureus

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Background Preterm delivery is a significant contributor to neonatal and infant morbidity and mortality. Preventive methods are preferable to treatment protocols for reducing perinatal mortality and morbidity. The calcium channel blocker nifedipine has the potential to be employed as a tocolytic, whereas the phosphodiesterase inhibitor sildenafil citrate promotes smooth muscle relaxation. Objective This study aims to examine the tocolytic effect of nifedipine in combination with sildenafil citrate in managing preterm labour (PTL). Methods After approval from the ethical board, 160 patients fulfilling the selection criteria were enrolled in the study from the outpatient and emergency department of obstetrics and gynaecology, University of Lahore, Pakistan. After taking written informed consent, their demographic profile, i.e., name, age, gestational age at presentation, parity, and expected date of delivery was noted. Patients were randomly assigned in a 1:1 ratio to two study groups (Group A: sildenafil citrate + nifedipine) and (Group B: nifedipine) using a computer-generated random number table to obtain a trial sequence. In group A, each patient was given nifedipine 20 mg orally, followed by 10 mg orally every eight hours for 48 hours and vaginal administration of sildenafil citrate, 25 mg at eight-hour intervals, for 48 hours. In group B, females were given nifedipine 20 mg orally, followed by 10 mg orally every 8 hours for 48 hours. They were kept admitted for 72 hours. SPSS Statistics version 21.0 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) was used to enter and analyse the collected data. Mean and standard deviation was calculated for quantitative variables like age, gestational age at presentation, gestational age at delivery, and BMI. Frequency and percentage were calculated for parity and preterm delivery. Results The study involved 160 patients, with the average age in Group A being 29.60±4.9 years and in Group B being 30.96±4.98 years. In terms of gestational age at delivery, Group A had an average of 34.16±1.7 weeks, while Group B had an average of 33.5±1.8 weeks (p-value<0.05). Preterm delivery was observed in 68.5% of Group A and 41.3% of Group B, with a significant p-value of 0.001. The study also discovered that the duration of prolonged pregnancy was significantly higher in Group A compared to Group B, with averages of 14.96±10.37 days and 10.24±8.97 days, respectively (p-value=0.002). Conclusion The results of this study suggest that the combination of sildenafil citrate and nifedipine may offer a promising new approach to improving pregnancy outcomes in cases of PTL. In the present study, sildenafil citrate plus nifedipine showed a significant effect in the management of PTL and prolongation in mean gestational age at delivery.

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Section: Introductionmentioning

confidence: 99%

A Comparison of Nifedipine Versus a Combination of Nifedipine and Sildenafil Citrate in the Management of Preterm Labour

Hassan,

Waseem,

AlDardeir

et al. 2023

Cureus

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Comparison of Fetomaternal Outcomes in Nifedipine Combined with Sildenafil Citrate Versus Nifedipine Alone for the Management of Threatened Preterm Labour

Faiz Rasul,

Shahzad,

Kanwal

et al. 2024

PJHS-Lahore

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Sildenafil, a smooth muscle relaxant, has been explored as an adjuvant to delay the onset of preterm labor. By inhibiting uterine contractions, it helps prolong pregnancy and improve fetal outcomes. Objectives: To evaluate the effects of Nifedipine on the mother and fetus during impending preterm labour, alone or with sildenafil citrate. Methods: The quasi-experimental trial was conducted at Sir Ganga Ram Hospital Lahore. Patients were randomly assigned to receive either 20 mg Nifedipine orally (stat dose) followed by 10 mg every 8 hours with 25 mg sildenafil citrate orally at 8-hour intervals or 20 mg without sildenafil citrate. The medication therapy lasted 72 hours. Chi-square and independent sample t-tests were used to compare groups in SPSS version 26.0. Results: Baseline age, gestational age and parity were similar in both groups (p>0.05). With mean gestational age at delivery 34.47 ± 2.18 weeks, the frequencies of term, preterm and very preterm were 15.0%, 77.5% and 7.5%, respectively. Nifedipine with Sildenafil citrate group had significantly higher term deliveries (30.0% vs. 0.0%; p-value=0.002) and normal weight births (35.0% vs. 5.0%; p=0.005) compared to Nifedipine alone group; however maternal readmission and neonatal intensive care unit admission rates were not statistically different between groups (p>0.05). There was no mortality feto-maternal observed. Conclusions: It was concluded that oral sildenafil citrate combined with Nifedipine is an effective option as tocolytic therapy for threatened preterm labour. The prolongation of pregnancy will improve fetal weight, and reduce neonatal intensive care unit admissions and preterm deliveries with minimum maternal and fetal side effects.

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Comparative Study between Nifedipine Alone Versus Nifedipine Combined with Sildenafil Citrate for Cases with Threatened Preterm Labour

Cited by 2 publications

References 0 publications

A Comparison of Nifedipine Versus a Combination of Nifedipine and Sildenafil Citrate in the Management of Preterm Labour

A Comparison of Nifedipine Versus a Combination of Nifedipine and Sildenafil Citrate in the Management of Preterm Labour

Comparison of Fetomaternal Outcomes in Nifedipine Combined with Sildenafil Citrate Versus Nifedipine Alone for the Management of Threatened Preterm Labour

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