Which One Is Better for Tocolysis in Pre-Term Labor?: Oral Nifedipine vs Transder-Mal Nitroglycerin Patch

Abstract

Introduction: Preterm labour follows a spontaneous commencement of labour in two-thirds of preterm birth instances. Obstetricians must consider both treatment options for the management of preterm. The study was conducted to compare the tocolytic effects of oral nifedipine tablets and transdermal nitroglycerine patches in preterm labor.
 Methodology: Cases with Singleton pregnancy, Pregnancy between 28 weeks to 36 completed weeks, and without contraindication for tocolysis were included in the study. Randomly assigned Nifedipine group received oral nifedipine (Tab Depin 10mg) and NTG group received transdermal nitroglycerine patch (Nitroderm 10). Progress was assessed for effect of drug for tocolysis.
 Results: Both groups were comparable in terms of demographic variable, vital measures, bishop score and cervical dilatation at the time of reporting. Comparison of mean prolongation duration according to gestational age in both the study groups indicate that overall duration of prolongation was better in oral nifedipine. However, the differences were not statistically significant. Headache and hypotension were significantly higher in Nitroglycerine patch compared to oral nifedipine group. The treatment discontinuation was significantly higher in Nitroglycerine patch compared to oral Nifedipine.
 Conclusion: Tocolytic effect of both, oral nifedipine and Nitroglycerine patch was statistically almost similar. However, considering the feasibility of application, availability, and cost of the drug, we recommend to use oral nifedipine for tocolysis over Nitroglycerine patch.