Atosiban Versus Nifedipin for the Management of Preterm Labor: A Prospective Study
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- Category: Vol. 81, September 2013
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Atosiban Versus Nifedipin for the Management of Preterm Labor: A Prospective Study, TAREK R. ABBAS
Abstract
Objective: This study to compare the effectiveness and the safety of atosiban (oxytocin antagonist) and nifedipin (calcium channel blocker) as a tocolytic agent in preterm labor.
Patients and Methods: This prospective randomized controlled study was performed in the Department of Obstetrics and Gynecology; Sharurah Armed forces Hospital (SAFH), Saudi Arabia. It involved one hundred and twenty pregnant women diagnosed with preterm labor at 24-34 gestational weeks from March 2012 to August 2013. They were random-ized to receive Atosiban intravenously (n=60) or Nifedipin orally (n=60) as a tocolytic. The two groups compared for effectiveness in delaying delivery for more than 48h in order to undergo steroid therapy, and also to assess their maternal safety.
Results: There was no statistically significant difference between the two groups in the effectiveness in treatment of preterm labor. Atosiban was effective in 81.7% of cases, and nifedipin in 75.0% of the cases (p-value=1.000), for delaying delivery for 48h. Atosiban was effective in 75% of the cases, and nifedipin in 65% of the cases, for delaying delivery for more than 7 days. The maternal side effects in the atosiban group were 18.3%, and in the nifedipin group they were 40%, which had a statistically significant difference (p<0.001). The duration between treatment and delivery was 31.06±16.12 days in the atosiban group and 24.61±14.6 days in the nifedipin group with no statistically significant difference (p=0.79).
Conclusion: Both Atosiban and Nifedipin are effective in treatment ofpreterm labour with a comparable effectiveness, but atosiban with less side effects and can be used in patients with heart diseases, and patient with multifetal pregnancy with minimal adverse effects.