Comparison of intramuscular progesterone with oral nifedipine for treating threatened preterm labor: A randomized controlled trial

Haghighi, Ladan; Rashidi, Mandana; Najmi, Zahra; Homam, Homa; Hashemi, Neda; Mobasseri, Alireza; Moradi, Yousef

doi:10.14196/mjiri.31.56

Cited by 7 publications

(7 citation statements)

References 31 publications

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“…One study compared single dose antibiotic prophylaxis to a multi-day course for routine C-section and found there was no significant difference in stillbirth or neonatal mortality between the two [ 97 ]. Vaginal progesterone for tocolysis in twin pregnancies was not found to increase gestational age at delivery [ 98 ], and a comparison of IM progesterone and nifedipine for threatened preterm labour found no significant change in either time to delivery or rates of Neonatal Intensive Care Unit (NICU) admission [ 99 ].…”

Section: Resultsmentioning

confidence: 99%

Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review

et al. 2021

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Background Reducing preterm birth and stillbirth and improving outcomes for babies born too soon is essential to reduce under-5 mortality globally. In the context of a rapidly evolving evidence base and problems with extrapolating efficacy data from high- to low-income settings, an assessment of the evidence for maternal and newborn interventions specific to low- and middle-income countries (LMICs) is required. Methods A systematic review of the literature was done. We included all studies performed in LMICs since the Every Newborn Action Plan, between 2013 - 2018, which reported on interventions where the outcome assessed was reduction in preterm birth or stillbirth incidence and/or a reduction in preterm infant neonatal mortality. Evidence was categorised according to maternal or neonatal intervention groups and a narrative synthesis conducted. Results 179 studies (147 primary evidence studies and 32 systematic reviews) were identified in 82 LMICs. 81 studies reported on maternal interventions and 98 reported on neonatal interventions. Interventions in pregnant mothers which resulted in significant reductions in preterm birth and stillbirth were (i) multiple micronutrient supplementation and (ii) enhanced quality of antenatal care. Routine antenatal ultrasound in LMICs increased identification of fetal antenatal conditions but did not reduce stillbirth or preterm birth due to the absence of services to manage these diagnoses. Interventions in pre-term neonates which improved their survival included (i) feeding support including probiotics and (ii) thermal regulation. Improved provision of neonatal resuscitation did not improve pre-term mortality rates, highlighting the importance of post-resuscitation care. Community mobilisation, for example through community education packages, was found to be an effective way of delivering interventions. Conclusions Evidence supports the implementation of several low-cost interventions with the potential to deliver reductions in preterm birth and stillbirth and improve outcomes for preterm babies in LMICs. These, however, must be complemented by overall health systems strengthening to be effective. Quality improvement methodology and learning health systems approaches can provide important means of understanding and tackling implementation challenges within local contexts. Further pragmatic efficacy trials of interventions in LMICs are essential, particularly for interventions not previously tested in these contexts.

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Section: Resultsmentioning

confidence: 99%

Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review

et al. 2021

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“…17 Nifedipine has better safety profile than beta agonists and MgSO4. 18 In present study, we compared the effectiveness of nifedipine against vaginal progesterone to prevent preterm labour. We found that vaginal progesterone is more effective than nifedipine for the prevention of preterm labour.…”

Section: Discussionmentioning

confidence: 99%

Is Vaginal Progesterone more Effective to Treat Threatened Preterm Labour than Oral Nifedipine?

Hafeez¹,

Khan²,

Khan³

et al. 2022

PJMHS

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Objective: To evaluate the efficacy of oral nifedipine against vaginal micronized progesterone to treat threatened premature labour (24 wks to 36+6 wks). Design : Randomized Controlled Trial. Setting : Obs and Gynae Deptt, Bakhtawar Hospital, Multan. Study Duration : Six months (15-12-20 to 14-6-21) Material and Methods: 126 patients with diagnosis of threatened preterm labour were included in this study. Baseline demographic information of patients (age, gestational age and parity, previous history of preterm labour, smoking, BMI and socioeconomic status) was recorded. In 63 patients oral nifedipine was given for treating threatened premature labour and in remaining 63 patients, progesterone was administered vaginally to prevent preterm labour.Efficacy was noted for both groups on a especially designed proforma. Results: Mean of ages of women included was 28.05±4.49 yrs. Mean GA of patients was 33.54±1.83 weeks. Mean parity was 1.81±1.11. Mean BMI of patients was 24.33±3.33 Kg/m2. Previous history of preterm labour was found in 16 (12.70%). Oral nifedipine was effective in 47 (74.60%) patients & vaginal progesterone was noted successful in 58 (92.10%) patients with p-value of 0.009. Conclusion: Vaginal micronized progesterone is more effective than oral nifedipine for the prevention of threatened preterm labour. More research work is required to ascertain the superiority of vaginal progesterone over nifedipine for the prevention of preterm labour. Keywords: Oral nifedipine, micronized progesterone, preterm labour.

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“…Drugs adverse effects were statistically significant among the 3 studied groups we had found that headache, palpitation and hot flushes more obvious in group I and II but less in group III (figure 3). Many previous studies had been discussed the efficacy of progesterone, calcium channel blockers or any of the other tocolytics in prevention of threatened preterm labor, from those studies, Ladan et al [24] studied the comparative efficiency between Nifedipine and intramuscular progesterone, the success rates with intramuscular progesterone and oral Nifedipine were 83% and 82.7%, respectively but there was no a statistically significant difference in the previously mentioned 2 agents concerning the gestational age at time of delivery, mode of delivery, neonatal birth weight, in the rate of NICU admission and hospitalization period, These results and findings were in harmony with that reported in our study as regards to neonatal outcome but in our study the prevalence of preterm labor was higher in Dydrogesterone than Nifedipine this may can be explained because of the route and type of progesterone was different from that used in Ladan et al…”

Section: Discussionmentioning

confidence: 99%

Sildenafil Citrate Versus Nifedipine and Dydrogesreone in Prevention of Preterm Labor with Short Cervix

Ali¹,

Abdallah²,

Abdelhamid³

2018

JOGRS

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Background: Prevention of the premature birth occurrence remains is considered one of the most tough challenges for obstetricians worldwide, mainly to avoid neonatal prematurity complications leading to short and long term morbidities additionally prematurity prevention will reduce premature neonatal mortality rates which is considered a major health concern of obstetricians, neonatologists and families. Objective: To compare and contrast the efficacy of Sildenafil citrate, Nifedipine and Dydrogesrone in prevention of premature labor in gestations with short cervix. Setting: Obstetrics & Gynecology Departments, Faculties of medicine, south Valley and Al-Azhar (Asyut) Universities, Egypt. Duration: from September 2014 to March 2018. Patients And Methds: the study was conducted on 300 pregnant women who randomly divided into three groups: Group I included 100 cases received Sildenafil citrate (Respatio tablet 20mg twice daily orally), Group II included 100 cases received Nifedipine (Epilat retard tablets 20mg twice daily orally) and Group III included 100 pregnant women received dydrogesreone 10 mg (Duphaston) twice daily orally. Results: incidence of preterm labor was (9.37, 8.51 and 14.28) in (Group I, Group II and Group II) respectively. Mean ± SD of cervical length at 32 weeks of gestation was mildly statistically significant among groups (p value <0.05) but no significance in neonatal outcome (p value >0.05) except birth weight which had a highly statistically significant difference (p value < 0.001). There was a highly statistically significant difference among studied groups as regard to drug side effects in (p value <0.001). Conclusion: Sildenafil citrate was as effective as Nifedipine and better than oral Dydrogesterone on myometrial relaxation and prevention of preterm birth in pregnant women who had short cervix.

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Comparison of intramuscular progesterone with oral nifedipine for treating threatened preterm labor: A randomized controlled trial

Cited by 7 publications

References 31 publications

Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review

Interventions to reduce preterm birth and stillbirth, and improve outcomes for babies born preterm in low- and middle-income countries: A systematic review

Is Vaginal Progesterone more Effective to Treat Threatened Preterm Labour than Oral Nifedipine?

Sildenafil Citrate Versus Nifedipine and Dydrogesreone in Prevention of Preterm Labor with Short Cervix

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