Comparison of the efficacy and adverse effects of nifedipine and indomethacin for the treatment of preterm labor.

Author(s): Kashanian M, Bahasadri S, Zolali B

Affiliation(s): Department of Obstetrics and Gynecology, Akbarabadi Teaching Hospital, Tehran University of Medical Sciences, Tehran, Iran. maryamkashanian@yahoo.com

Publication date & source: 2011-06, Int J Gynaecol Obstet., 113(3):192-5. Epub 2011 Apr 1.

Publication type: Comparative Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

OBJECTIVE: To compare the effectiveness and adverse effects of nifedipine versus indomethacin in the treatment of preterm labor. METHODS: In a randomized clinical trial, 79 women with labor pain at 26-33 weeks of gestation were treated with either oral nifedipine (n=40) or rectal indomethacin (n=39). RESULTS: Twenty-three (59%) women in the indomethacin group, and 10 (25%) in the nifedipine group did not respond to treatment (P=0.002). None of the 16 and 30 women remaining in the indomethacin and nifedipine groups, respectively, delivered during the subsequent 48 hours. Of these remaining women, 1 (6.25%) in the indomethacin group and 4 (13.3%) in the nifedipine group delivered between 48 hours and 7 days (P=0.162). For the women who responded to treatment, the mean gestational age at time of delivery was 238.5+/-19.4 days and 246.4+/-15.4 days in the nifedipine and indomethacin groups, respectively (P=0.182). Seventeen (42.5%) women in the nifedipine group, and 11 (28.2%) in the indomethacin group showed adverse effects (P=0.184). CONCLUSION: Indomethacin was less effective than nifedipine for the fast treatment of preterm labor. For women who responded to treatment within 2 hours, however, the delaying of delivery by indomethacin was similar to that by nifedipine. Copyright (c) 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.