Comparison of Efficacy of Nifedipine Alone Versus Nifedipine and Progesterone in the Treatment of Threatened Preterm Labour

Background: One of the main causes of infant morbidity and mortality is preterm birth, which is defined as delivery before 37 weeks of gestation. Tocolytic therapy is essential to delay delivery, allowing corticosteroid administration for fetal lung maturation. Nifedipine is an effective tocolytic, and progesterone may enhance uterine quiescence. Methods: A prospective comparative study was conducted at Shifa International Hospital, Islamabad, over 12 months. A total of 130 women with singleton pregnancies between 24–37 weeks diagnosed with threatened preterm labor were enrolled and assigned to treatment groups based on clinical management: Group A received nifedipine alone, and Group B received nifedipine plus progesterone. Uterine contractions and maternal side effects were monitored. Data were analyzed using SPSS v22, with chi-square and t-tests applied; p≤0.05 was considered significant. Results: Cessation of contractions within 48 hours occurred in 47.7% of Group A and 72.3% of Group B (χ²=8.56, p=0.003). Mean time to cessation was shorter in Group B (21.7 ± 7.0 hours) than Group A (29.4 ± 8.2 hours, t=3.38, p=0.001). Maternal side effects were mild; vaginal discomfort occurred only in the combination group (7.7%, p=0.03). Stratification by age, parity, and gestational age did not alter these outcomes. Conclusion: Nifedipine combined with progesterone was more effective than nifedipine alone for threatened preterm labor, with minimal side effects, suggesting a safe and efficient approach to improve maternal and neonatal outcomes.