Objective: to evaluate the efficacy of prophylactic nifedipine versus placebo in reducing spontaneous preterm delivery in asymptomatic women at high risk for preterm delivery.
Background: Preterm birth (before 37 completed weeks of gestation) is a major cause of death and a significant cause of long-term loss of human potential. Prophylactic nifedipine in reducing spontaneous preterm delivery in asymptomatic women at high risk for preterm deliver
Patients and methods: A Prospective randomized double-blinded study was carried out on 120 pregnant women at high risk of preterm labor (5 cases lost in follow-up), (5 discontinued before 28 days because they had preterm delivery or drug side effects) which attended from the Obstetrics and Gynecology outpatient clinic in Minoufia University Hospital during the period from March 2016 to August 2017. Detailed history, laboratory investigations, obstetric and ultrasound follow up study were done.
Results: there was no significant difference (P > 0.5) between nifedipine and placebo groups regarding maternal age, gestational age, parity, Previous preterm labor and Inter pregnancy interval (years). While, there was statistically significant difference (P ≤ 0.05) regarding mode of delivery, delivery time and medications side effects, neonatal respiratory distress and neonatal Intensive care unit (NICU) admission in both group. Additionally, onset of labor between 34-37 week was significantly less frequent in nifedipine group than placebo group.
Conclusion: we found that the superiority of nifedipine as prophylactic tocolosysis in the mean prolongation of pregnancy compared to that of placebo in high risk women for preterm labor, it has better effect on neonatal outcomes, fewer maternal side effects. We would only comment that nifedipine looks like a promising drug in this regard and further large studies are required to establish this fact.