Comparison of the effect of vaginal progesterone and oral nifedipine for maintenance tocolysis after arrested preterm labour, to prolong the pregnancy and the neonatal outcome

Background: Preterm birth is a major determinant of neonatal morbidity and mortality and has long term adverse consequences. It is defined as childbirth occurring at less than 37 weeks of gestation. Various drugs with different doses and routes have been used for maintenance tocolysis has been used. Aims and objectives were to compare the effect of vaginal progesterone and oral nifedipine for maintenance tocolysis after arrested preterm labour and their effect concerning the neonatal outcomes. Methods: This study was conducted in the department of obstetrics and gynecology, Mata Chanan Devi hospital, New Delhi in collaboration with the department of pediatrics. The 90 pregnant women who fulfilled inclusion criteria were recruited and were randomized into 2 groups namely nifedipine and progesterone group. Results: The mean gestational age at delivery in the nifedipine group was 35 weeks, while in the progesterone group it was 37 weeks, and it was a significant difference (p=0.002). There was a significant difference in the prolongation of pregnancy between both the groups (p<0.001). Mean prolongation of pregnancy in the nifedipine group was 18 days, and 38 days in the progesterone group which was significant (p=0.000). The mean APGAR score at five minutes was 7 for the nifedipine group and 8 for the progesterone group. The mean duration of the NICU stay was 5 days in the nifedipine group and 2 days in the progesterone group. Conclusions: Progesterone was found to be a better drug for maintenance tocolysis compared to nifedipine. It is associated with better maternal and perinatal outcomes when used as a maintenance tocolytic as compared to nifedipine.