COMPARATIVE STUDY OF

NIFEDIPINE AND ISOXSUPRINE IN

THE PREVENTION OF PRETERM
LABOR

Moh Aswandi HS, S.Ked

Mentor : dr Abdul Faris, Sp.OG (K)

PART OF OBSTETRY AND GYNECOLOGY

SCIENCE OF FACULTY OF MEDICAL
ALKHAIRAAT UNIVERSITY OF PALU
ABSTRACT
 Background: A prospective study was conducted
to compare the efficacy of nifedipine compared
with isoxsuprine in preventing preterm labor and
also to evaluate maternal side effects and
neonatal outcomes.
ABSTRACT
 Method: This study is a randomized prospective
comparative study conducted at the MGM
hospital and research center, Patna, Bihar
between 15/03/2014 to 15/02/2016. 75 antenatal
women with a gestational age between 28 and 36
weeks were selected who met the criteria for the
study.
PRELIMINARY

 Preterm labor remains one of the unbeatable

limits in the current era of midwifery. The
incidence is around 7-9% of pregnancies which
account for three-quarters of mortality and
morbidity among newborns without congenital
anomalies. Preterm labor occurs in as many as
11% in the United States or even greater in
developing countries (23.3% in India) and
accounts for 40-75% of neonatal deaths
PRELIMINARY

 For group 1, those receiving nifedipine were

given initial 20mg of oral nifedipine followed by
10mg at a four-hour interval for 48 hours. If the
contraction lasts after 90 minutes, the first 10 mg
dose starts at the same time.
PRELIMINARY

 For group 2, patients were started at an injection

of isoxsuprine 40mg in 500ml lactate ringer at a
rate of 0.08mg / minute, the infusion rate was
increased to 0.24mg / minute depending on the
status of uterine contractions and side effects.
After cessation of intravenous infusion, the
patient was maintained on oral isoxsuprine 10
mg every eight hours for up to 7 days.
RESULTS
Table 1: Mean prolongation of delivery

Nifedipine Isoxsuprine

Age (years) 22,2±5,5 23,4±4,6

Parity

Primgravida 67 (90%) 60 (80%)

Multigravida 8 (10%) 15 (20%)

Gestation at treatment (in Weeks) 30,5±3,5 31,4±2,8

Mean prolongation of delivery (in days) 22,4±15,6 16,5±4,5

 RESULTS
Table 2: Pregnancy outcomes.

Nifedipine n (%) Isoxsuprine n (%)

Success 67 (90%) 57 (76%)

Failure 8 (10%) 18 (24%)

Total 75 (100%) 75 (100%)

 RESULTS
Table 3: Side effects.

Nifedipine n (%) Isoxsuprine n (%)

Tachycardia 35 (76%) 42 (50%)

Hypotension 15 (20%) 27 (36%)

Nausea/Vomiting 7 (10%) 25 (34%)

Chest pain 3 (4%) 7 (10%)

Pulmonary edema 0 7 (2%)

Hot flushes (transient) 30 (40%) 26 (39%)

Headache 27 (30%) 9 (12%)

DISCUSSION
 In this study, it was found that tocolysis delayed
labor in 90% of the total cases and had a
maximum effect at 28-34 weeks' gestation. This
delay in labor allows time for steroids to
accelerate lung maturity and neonatal survival.
DISCUSSION
 Isoxsuprine is the first class of sympathomimetic beta
agonist drugs to be used to inhibit preterm labor in
1961. This drug works by stimulating adrenergic b
receptors in the uterus
 Nifedipine, is a calcium channel blocker class that was
first used clinically as a tocolytic by Ulmsten et al. in
1980, calcium antagonists were smooth muscle
relaxants which inhibited uterine activity through a
calcium channel
DISCUSSION
 In this study, no significant differences were
found in maternal and neonatal side effects but
lower side effects were seen with nifedipine.
 In this study, transient hypotension, nausea,
vomiting, tachycardia, chest pain, successive
headaches were 20%, 10%, 46%, 4%, 30%
observed in the nifedipine group.
CONCLUSION
 There is a high incidence of preterm labor in
India. This study found that nifedipine had
better tocolytic efficacy, fewer side effects and
better tolerability compared to isoxsuprine
THANK YOU