Publication:

Tocolytic effect of combined sildenafil citrate and nifedepine versus nifedipine alone for management of preterm labour at a tertiary centre

Background This study was conducted to evaluate tocolytic effect of sildenafil citrate and nifedipine versus nifedipine alone for management of preterm labour.

Methods Prospective randomized study on 80 women aged 18-35 years with singleton pregnancy of 28-34 weeks gestation with preterm labour, fulfilling the inclusion criteria were randomly divided in two groups of 40 each. In regimen A women were given sildenafil citrate and nifedipine while in regimen B nifedipine alone for 72 hours as tocolysis.

Results Higher mean latency in sildenafil and nifedipine combination regimen compared to nifedipine alone regimen (28.23±18.3 versus 12.98±13.35 days, p<0.001). In regimen A, less days of hospital stay (3.23±0.92 versus 3.9±0.38 days, p<0.0001); improve perinatal outcomes in form of fewer deliveries during hospitalization or within 7 days after discharge (p=0.018); reduction in NICU admission (0.68±1.54 versus 3.18±4.61 days, p=0.002); improvement in birth weight (p<0.001) and fewer neonatal complications. Only minor side-effects like facial flushing (42.5% versus 22.5%, p=0.029), headache (40% versus 25%), dyspepsia (15% versus 2.5%, p=0.047), nasal congestion, palpitation, hypotension, constipation, nausea, dizziness were seen.

Conclusions Our study found combination of sildenafil citrate with nifedipine as superior and successful regimen with future potential as a tocolytic therapy.