Goyal Nidhi, Agrawal Manjusha, Dewani Deepika, Reddy Eleti Manila
Department of Obstetrics and Gynaecology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2023 May 16;15(5):e39106. doi: 10.7759/cureus.39106. eCollection 2023 May.
Backgrounds A significant contributor to newborn morbidity and mortality is preterm birth. Several techniques have been employed to identify patients at risk of premature labour. However, these predictors are not always effective because of their multifactorial aetiology. Preterm labour can be suppressed largely through tocolysis. This study compared the effectiveness and safety of transdermal nitroglycerine and oral nifedipine in preventing premature labour. Methods This study was done at Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, from December 2020 to November 2022, on 130 women presenting with preterm labour pains between 28 and 37 weeks of gestational age. All the women selected were randomized into two equal groups by using the envelope method. Sixty-five women were given a nitroglycerine patch (Group A), and the rest (65 women) were given an oral nifedipine tablet (group B). The variables studied were mean days of prolongation of pregnancy, treatment outcome, steroid coverage, along with feto-maternal outcomes among both groups. Results The percentage of women whose pregnancy was prolonged for at least 48 hours in the nitroglycerine group was 75.3%, and in the nifedipine group it was 93.8%. Failure to achieve tocolysis, defined as delivery within 48 hours, was seen significantly more in the nitroglycerine group (24.6%) than in the nifedipine group (6.1%). The overall foetal outcomes were comparable in both groups. Conclusion Oral nifedipine was found to be superior to transdermal nifedipine patches in terms of efficacy and safety in the management of preterm labour, with a better side effect profile.
早产是新生儿发病和死亡的一个重要因素。已经采用了几种技术来识别有早产风险的患者。然而,由于早产的病因是多因素的,这些预测指标并不总是有效。早产可以通过宫缩抑制剂在很大程度上得到抑制。本研究比较了经皮硝酸甘油和口服硝苯地平预防早产的有效性和安全性。
本研究于2020年12月至2022年11月在马哈拉施特拉邦瓦尔达市萨万吉的阿查里亚·维诺巴·巴韦农村医院对130名孕28至37周出现早产阵痛的妇女进行。所有入选妇女采用信封法随机分为两组。65名妇女给予硝酸甘油贴片(A组),其余65名妇女给予口服硝苯地平片(B组)。研究的变量包括妊娠延长的平均天数、治疗结果、类固醇使用情况以及两组的母婴结局。
硝酸甘油组妊娠至少延长48小时的妇女百分比为75.3%,硝苯地平组为93.8%。硝酸甘油组(24.6%)未实现宫缩抑制(定义为48小时内分娩)的情况明显多于硝苯地平组(6.1%)。两组的总体胎儿结局相当。
在早产管理的有效性和安全性方面,发现口服硝苯地平优于经皮硝酸甘油贴片,且副作用更小。