Volume 21, Issue 5 (May 2023)                   Int J Reprod BioMed. 2023, 21(5): 379-386 | Back to browse issues page


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Nasrolahei S, Hosseini S A, Hosseini S A, Hosseini S N K, Hosseini S S, Moradian Lotfi P. Effect of nifedipine with and without sildenafil citrate for the management of preterm labor in pregnant women: A randomized clinical trial. Int J Reprod BioMed. 2023; 21 (5) :379-386
URL: http://ijrm.ir/article-1-2511-en.html
1- Department of Obstetrics and Gynecology, School of Medicine Endometrium and Endometriosis Research Center, Fatemieh Hospital, Hamadan University of Medical Sciences, Hamadan, Iran., Ayatollah Mousavi Hospital, Above Shahid Sabouti Blvd., Gavazang Road, Zanjan, Iran. Postal Code: 6517838695
2- Department of Obstetrics and Gynecology, Zanjan University of Medical Sciences, Zanjan, Iran. , dr.seyedeh_arezoo_hoseini@yhoo.com
3- Iran University of Medical Sciences, Tehran, Iran., Ayatollah Mousavi Hospital, Above Shahid Sabouti Blvd., Gavazang Road, Zanjan, Iran. Postal Code: 6517838695
4- Bahçeşehir Medical University Istanbul Turkey, Istanbul, Turkey., Ayatollah Mousavi Hospital, Above Shahid Sabouti Blvd., Gavazang Road, Zanjan, Iran. Postal Code: 6517838695
5- Hamadan University of Medical Sciences, Hamadan, Iran., Ayatollah Mousavi Hospital, Above Shahid Sabouti Blvd., Gavazang Road, Zanjan, Iran. Postal Code: 6517838695
Abstract:   (2412 Views)
Background: Preterm labor is one of the main causes of neonatal mortality and its treatment is still challenging.
Objective: The study aimed to compare the effectiveness of nifedipine (Nif) with and without sildenafil citrate (SC) for the treatment of preterm labor in pregnant women.
Materials and Methods: In this clinical trial study, 126 pregnant women referred to the Fatemieh hospital, Hamadan, Iran with a complaint of preterm labor were evaluated. Participants were randomly divided into 2 groups of Nif 20 mg orally (single dose), then 10 mg every 6-hr, and at the same time vaginal SC 25 mg every 8 hr (Nif + SC) or Nif alone. Treatment was continued for 48-72 hr if uterine contractions did not resolve in both groups. Delivery rates at the time of hospitalization and neonatal outcome were compared between the 2 groups.
Results: No statistically significant difference was observed between the 2 study groups in terms of mean age, gestational age, body mass index, and parity. 76.2% of Nif + SC participants in the first 72 hr of hospitalization and 57.2% of Nif participants remained without delivery (p = 0.02). The neonatal hospitalization rate of the Nif + SC group in the neonatal intensive care unit was 25.4% and in the Nif group was 42.9% (p = 0.03).
Conclusion: Nif with SC is superior to Nif alone in women at risk of preterm labor due to increasing gestational age and better neonatal outcomes.
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Type of Study: Original Article | Subject: Pregnancy Health
* Corresponding Author Address: Ayatollah Mousavi Hospital, Above Shahid Sabouti Blvd., Gavazang Road, Zanjan, Iran. Postal Code: 6517838695

References
1. Suff N, Story L, Shennan A. The prediction of preterm delivery: What is new? Semin Fetal Neonatal Med 2019; 24: 27-32. [DOI:10.1016/j.siny.2018.09.006] [PMID]
2. Jacobsson B, Pettersson K, Modzelewska D, Abrahamsson T, Bergman L, Håkansson S. [Preterm delivery: An overview on epidemiology, pathophysiology and consequences for the individual and the society]. Lakartidningen 2019; 116: FR6F. (in Swedish)
3. Fritz T, Källén K, Maršál K, Jacobsson B. Outcome of extremely preterm infants after iatrogenic or spontaneous birth. Acta Obstet Gynecol Scand 2018; 97: 1388-1395. [DOI:10.1111/aogs.13387] [PMID]
4. Sebastian E, Bykersma C, Eggleston A, Eddy KE, Chim ST, Zahroh RI, et al. Cost-effectiveness of antenatal corticosteroids and tocolytic agents in the management of preterm birth: A systematic review. EClinicalMedicine 2022; 49: 101496. [DOI:10.1016/j.eclinm.2022.101496] [PMID] [PMCID]
5. Patel SS, Ludmir J. Drugs for the treatment and prevention of preterm labor. Clin Perinatol 2019; 46: 159-172. [DOI:10.1016/j.clp.2019.02.001] [PMID]
6. Lamont RF, Jørgensen JS. Safety and efficacy of tocolytics for the treatment of spontaneous preterm labour. Curr Pharm Des 2019; 25: 577-592. [DOI:10.2174/1381612825666190329124214] [PMID]
7. Ferreira RS, Negrini R, Bernardo WM, Simões R, Piato S. The effects of sildenafil in maternal and fetal outcomes in pregnancy: A systematic review and meta-analysis. PLoS One 2019; 14: e0219732. [DOI:10.1371/journal.pone.0219732] [PMID] [PMCID]
8. Ala M, MohammadJafari R, Dehpour AR. Sildenafil beyond erectile dysfunction and pulmonary arterial hypertension: Thinking about new indications. Fundam Clin Pharmacol 2021; 35: 235-259. [DOI:10.1111/fcp.12633] [PMID]
9. Mohammadi E, Noei Teymoordash S, Norouzi AR, Norouzi F, Norouzi HR. Comparison of the effect of nifedipine alone and the combination of nifedipine and sildenafil in delaying preterm labor: A randomized clinical trial. J Family Reprod Health 2021; 15: 112-117. [DOI:10.18502/jfrh.v15i2.6452] [PMID] [PMCID]
10. Mokhtari G, Hamidi Madani A, Kazemnezhad Leyli E, Jafari A. Sildenafil citrate effects on seminal parameters in male participants with idiopathic infertility; A randomized, double-blind, controlled cross-over clinical trial study. Urol Sci 2022; 33: 93-98. [DOI:10.4103/UROS.UROS_113_21]
11. Hanley M, Sayres L, Reiff ES, Wood A, Grotegut CA, Kuller JA. Tocolysis: A review of the literature. Obstet Gynecol Surv 2019; 74: 50-55. [DOI:10.1097/OGX.0000000000000635] [PMID]
12. Kashanian M, Shirvani Sh, Sheikhansari N, Javanmanesh F. A comparative study on the efficacy of nifedipine and indomethacin for prevention of preterm birth as monotherapy and combination therapy: A randomized clinical trial. J Matern Fetal Neonatal Med 2020; 33: 3215-3220. [DOI:10.1080/14767058.2019.1570117] [PMID]
13. Ibrahim MH, Elfaki T, Elhassan EM, Abdelrahiem SK, Adam I. The effectiveness of nifedipine/indomethacin combination therapy and nifedipine monotherapy for postponing preterm birth (25-34 weeks of gestation) in Sudanese women: A randomized clinical trial study protocol. BMC Pregnancy Childbirth 2021; 21: 457. [DOI:10.1186/s12884-021-03951-x] [PMID] [PMCID]
14. van Winden TMS, Nijman TAJ, Kleinrouweler CE, Salim R, Kashanian M, Al-Omari WR, et al. Tocolysis with nifedipine versus atosiban and perinatal outcome: An individual participant data meta-analysis. BMC Pregnancy Childbirth 2022; 22: 567. [DOI:10.1186/s12884-022-04854-1] [PMID] [PMCID]
15. Conde-Agudelo A, Romero R, Kusanovic JP. Nifedipine in the management of preterm labor: A systematic review and metaanalysis. Am J Obstet Gynecol 2011; 204: 134. e1-20. [DOI:10.1016/j.ajog.2010.11.038] [PMID] [PMCID]
16. Lotfalizadeh M, Teymoori M. [Comparison of nifedipine and magnesium sulfate in the treatment of Preterm]. Iran J Obstet Gynecol Infertil 2010; 13: 7-12. (In Persian)
17. Nikbakht R, Taheri Moghadam M, Ghane'ee H. Nifedipine compared to magnesium sulfate for treating preterm labor: A randomized clinical trial. Iran J Reprod Med 2014; 12: 145-150.
18. Abd El-Ghader AN, Ali AE-N, Abdallah KhM, Abdelhamid A. Sildenafil citrate versus nifedipine and dydrogesreone in prevention of preterm labor with short cervix. J Obstet Gynecol Reprod Sci 2018; 2. [DOI:10.31579/2578-8965/009]
19. Turner J, Dunn L, Tarnow-Mordi W, Flatley C, Flenady V, Kumar S. Safety and efficacy of sildenafil citrate to reduce operative birth for intrapartum fetal compromise at term: A phase 2 randomized controlled trial. Am J Obstet Gynecol 2020; 222: 401-414. [DOI:10.1016/j.ajog.2020.01.025] [PMID]
20. Chiossi G, Costantine MM, Betancourt A, Hankins GDV, Longo M, Saade GR, et al. Does sildenafil citrate affect myometrial contractile response to nifedipine in vitro? Am J Obstet Gynecol 2010; 203: 252. e1-5. [DOI:10.1016/j.ajog.2010.05.007] [PMID]
21. Khan RN, Hamoud H, Warren A, Wong LF, Arulkumaran S. Relaxant action of sildenafil citrate (Viagra) on human myometrium of pregnancy. Am J Obstet Gynecol 2004; 191: 315-321. [DOI:10.1016/j.ajog.2003.11.005] [PMID]

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