International Journal of Reproductive BioMedicine
International Journal of Reproductive BioMedicine
IJRM
Medical Sciences
http://ijrm.ir
1
admin
2476-4108
2476-3772
10.29252/ijrm
en
jalali
1402
2
1
gregorian
2023
5
1
21
5
online
1
fulltext
en
تأثیر نیفیدیپین با و بدون سیلدنافیل سیترات بر درمان زایمان زودرس در زنان باردار: یک کارآزمایی بالینی
Effect of nifedipine with and without sildenafil citrate for the management of preterm labor in pregnant women: A randomized clinical trial
Pregnancy Health
Original Article
Original Article
<div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">زایمان زودرس یکی از علل اصلی مرگ­و­میر نوزادان می­باشدکه مدیریت درمان آن همچنان چالش­برانگیز است.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">از انجام این مطالعه مداخلهای مقایسه اثربخشی نیفیدیپین به تنهایی یا همراه با سیلدنافیل سیترات در درمان زایمان زودرس در زنان باردار بود.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">مواد و روش ­ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">در این مطالعه کار آزمایی بالینی 126 زن باردار 15 تا 45 ساله که با شکایت زایمان زودرس به بیمارستان فاطمیه همدان در سال 1399 مراجعه کردند بررسی شدند. بیماران بهطور تصادفی و مساوی به دو گروه نیفیدیپین (</span></span><span dir="LTR" style="font-size:10.0pt">Nif</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">) 20 میلی­گرم خوراکی (تک دوز)، سپس 10 میلی­گرم به فاصله هر 6 تا 8 ساعت و همزمان سیلدنافیل (</span></span><span dir="LTR" style="font-size:10.0pt">Nif+SC</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">) واژینال 25 میلیگرم هر 8 ساعت و یا نیفیدیپین (</span></span><span dir="LTR" style="font-size:10.0pt">Nif</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">) به تنهایی قرار گرفتند. درمان 48 تا 72 ساعت در صورت عدم برطرف شدن انقباضات رحمی در هر دو گروه تکرار شد. میزان زایمان در زمان بستری و پیامد نوزادان بین دو گروه مقایسه شد.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">هر دو گروه مطالعه از نظر میانگین سنی، سن بارداری، شاخص توده بدنی و پاریتی تفاوت آماری معنیداری نداشتند. 2/76% بیماران گروه </span></span><span dir="LTR" style="font-size:10.0pt">Nif+SC</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">در 72 ساعت اول بستری و 2/57% بیماران گروه </span></span><span dir="LTR" style="font-size:10.0pt">Nif</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">بدون زایمان باقی ماندند (02/0 </span></span><span lang="FA" style="font-size:10.0pt">=</span><span dir="LTR" style="font-size:10.0pt">p</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">). میزان بستری نوزادان گروه </span></span><span dir="LTR" style="font-size:10.0pt">Nif+SC</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> در بخش مراقبت ویژه 4/25% و در گروه </span></span><span dir="LTR" style="font-size:10.0pt"> Nif</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">9/42% بود (03/0 </span></span><span lang="FA" style="font-size:10.0pt">= </span><span dir="LTR" style="font-size:10.0pt">p</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">). </span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">نتیجه ­گیری:</span></span></b> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">نیفیدیپین همراه با سیلدنافیل سیترات در زنان با خطر زایمان زودرس به دلیل افزایش سن حاملگی و پیامد بهتر نوزادان نسبت به نیفیدپین به تنهایی برتری دارد.</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></span></span></span></span></span></div>
<div style="text-align: justify;"><span style="font-size:11pt"><span style="tab-stops:0in"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Background:</span></span></b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> Preterm</span></span> <span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">labor is one of the main causes of neonatal mortality and its treatment is still challenging. </span></span></span></span></span><br>
<span style="font-size:11pt"><span style="tab-stops:0in"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Objective:</span></span></b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> The study aimed to compare the effectiveness of nifedipine (Nif) with and without sildenafil citrate (SC) for the treatment of </span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">preterm labor</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> in pregnant women.</span></span></span></span></span><br>
<span style="font-size:11pt"><span style="tab-stops:0in"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Materials and Methods:</span></span></b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> In this clinical trial study, 126 pregnant women</span></span> <span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">referred to the Fatemieh hospital, Hamadan, Iran with a complaint of </span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">preterm labor</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> 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 (</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Nif + SC)</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> or </span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Nif</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> 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.</span></span></span></span></span><br>
<span style="font-size:11pt"><span style="tab-stops:0in"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Results:</span></span></b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> 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 </span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">participants</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> in the first 72 hr of hospitalization and 57.2% of Nif </span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">participants</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> 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). </span></span></span></span></span><br>
<span style="font-size:11pt"><span style="tab-stops:0in"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Conclusion:</span></span></b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> Nif with SC is superior to Nif alone in women at risk of preterm </span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">labor</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> due to increasing gestational age and better neonatal outcomes.</span></span></span></span></span></div>
نیفیدپین, زایمان, سلیدانافیل سیترات, کارآزمایی بالینی.
Nifedipine, preterm labor, Sildenafil citrate, Randomized trial.
379
386
http://ijrm.ir/browse.php?a_code=A-10-2160-1&slc_lang=en&sid=1
Shahla
Nasrolahei
Dr-nasrolhi@yahoo.com