COMPARING EFFECTS OF NIFEDIPIN AND INDOMETHACIN ON TREATMENT OF PRETERM LABOR AND THEIR COMPLICATIONS

Preterm labor is one of the most important obstetrics problems that is the most common cause of neonatal mortality and finding an effective treatment with least adverse effects is always under serious concern. The purpose of the present study is to compare the efficacy of two tocolytic agents of nifedipin and indomethacin for treatment of preterm labor and their complications.

Materials & Methods: This randomized clinical trial study was conducted on 79 pregnant women who were admitted for labor pain at 26-33 weeks of gestation. The women were randomly assigned into the two groups. In the nifidipin group (40 cases), oral nifedipin and in the indomethacin group (39 cases), indomethacin were prescribed rectally. Then the women were evaluated for the response to treatment during two hours, and delaying of delivery for 48 hours and seven days and drug's adverse effects. All women were followed up to delivery, and the interval between drug administration and delivery was evaluated too.

Results: According to the findings, the two groups did not have significant difference according to maternal age, gestational age, cervical dilatation, effacement and consistency. 23 cases (59%), of indomethacin group, and 10 cases (25%) of nifedipin group did not respond to treatment which was statistically significant (P=0.002).None of the 16 remaining women of indomethacin group and 30 cases of nifedipin group delivered during 48 hours. One woman (6.25%) in the indomethacin group and 4 cases (13.3%) of nifedipin group delivered between 48 hours- 7 days with no significant difference. The mean gestational age at the time of delivery (for the women who responded to treatment during the first 2 hours) was 238.5± 19.4 days and 246. 4± 15.4 days in the nifedipin and indomethacin groups respectively and did not show significant differences (P=0.182). 17 cases (42.5) of nifedipin group and 11 cases (28.2%) of indomethacin group showed adverse effects (P=0.184).

Conclusion: Indomethacin is less effective than nifedipin for the fast treatment of preterm labor, but in women who respond to treatment during two hours, delaying of delivery is similar to nifedipin.