Tocolytic effect of combined sildenafil citrate and nifedepine versus nifedipine alone for management of preterm labour at a tertiary centre

Abstract

Background: This study was conducted to evaluate tocolytic effect of sildenafil citrate and nifedipine versus nifedipine alone for management of preterm labour.Methods: Prospective randomized study on 80 women aged 18-35 years with singleton pregnancy of 28-34 weeks gestation with preterm labour, fulfilling the inclusion criteria were randomly divided in two groups of 40 each. In regimen A women were given sildenafil citrate and nifedipine while in regimen B nifedipine alone for 72 hours as tocolysis.Results: Higher mean latency in sildenafil and nifedipine combination regimen compared to nifedipine alone regimen (28.23±18.3 versus 12.98±13.35 days, p<0.001). In regimen A, less days of hospital stay (3.23±0.92 versus 3.9±0.38 days, p<0.0001); improve perinatal outcomes in form of fewer deliveries during hospitalization or within 7 days after discharge (p=0.018); reduction in NICU admission (0.68±1.54 versus 3.18±4.61 days, p=0.002); improvement in birth weight (p<0.001) and fewer neonatal complications. Only minor side-effects like facial flushing (42.5% versus 22.5%, p=0.029), headache (40% versus 25%), dyspepsia (15% versus 2.5%, p=0.047), nasal congestion, palpitation, hypotension, constipation, nausea, dizziness were seen.Conclusions: Our study found combination of sildenafil citrate with nifedipine as superior and successful regimen with future potential as a tocolytic therapy.

Effect of oral nifedipine or combined with sildenafil citrate for management of threatened preterm labour randomized trial

“…In this study, majority of the participants in groups A and B belonged to primigravida with 86.67% and 73.33%, respectively. Urmila Karya et al 12 conducted a prospective randomized study on 80 women in which majority of the participants in the nifedipine and combination group belonged to multigravida with 65% and 62.5%, respectively, which was contradictory to our study.…”

“…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%. In Urmila Karya et al 12 study, facial flushing, palpitations, headache, and nausea were the side effects identified within the nifedipine group with 22.5%, 10%, 25%, and 7.5%, and was 42.5%, 7.5%, 40%, and 5% respectively which resembles our study.…”

“…Most of the women had gestational ages between 33-35weeks in groups A and B with 50% and 63.33%, respectively. In Urmila Karya et al 12 study majority of participants had gestational age between 32-34 weeks in the nifedipine and combination group with 60% and 55%, respectively, which resembles our study.…”

“…In the current study, respiratory distress syndrome, NICU admission, perinatal death, alive and healthy neonates were 16.67%, 23.33%, 20%, and 53.33% in group A, and was 23.33%, 36.67%, 3.33%, and 56.67% respectively in group B. In Urmila Karya et al 12 study the respiratory distress and perinatal death were 22.5%, 35%, and 12.5% in the nifedipine group and was 10%, 22.5%, and 5% in the combination group.…”