Nifedipine and indomethacin in preventing preterm labor under 32 gestational weeks

Abstract

Aims:This study compared nifedipine and indomethacin treatments, commonly used tocolytic agents, in terms of efficacy and maternal side effects.Methods:This retrospective study included pregnant women spontaneous preterm labor between 24 and 32 weeks of gestation who were treated with indomethacin or nifedipine between January 2017 and June 2020. Subjects with polyhydramnios, multiple pregnancies, preterm premature rupture of membranes, and those with 4 cm or more cervical dilatation, and who required emergency cesarean delivery were excluded. Study endpoints were delivery within 48 h, prolongation of pregnancy up to 34 weeks and 37 weeks, and maternal side effects.Results:A total of 307 pregnant women were analyzed. Nifedipine and indomethacin were administered to 205 and 102 patients, respectively. The median maternal age was 25 years in both groups. The rate of delivery within 48 h was significantly higher by 20.6% among subjects who received indomethacin compared with the 9.8% delivery rate among subjects who received nifedipine (p=0.009). However, delivery after gestational 34 weeks and 37 weeks were significantly higher in the nifedipine group (p<0.001 and p=0.003, respectively). No patients in the indomethacin group had side effects, but 6.8% of the nifedipine group required drug change due to side effects.Conclusions:This study showed that nifedipine was superior to indomethacin in achieving a 48-hour delay in preterm labor, increasing the gestational age at birth, and decreasing the preterm delivery rates.

Keywords

• indomethacin
• nifedipine
• preterm labor
• tocolytic agents