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66.92
Volume 4, Issue 2 (2023)                   J Clinic Care Skill 2023, 4(2): 91-96 | Back to browse issues page
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Gholami L, Zare H, Afroughi S, Eslamnik P. Comparing the Effect of Nifedipine and Indomethacin on Pregnant Women with Idiopathic Preterm Labor. J Clinic Care Skill 2023; 4 (2) :91-96
URL: http://jccs.yums.ac.ir/article-1-192-en.html
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1- Nursing Department, School of Nursing, Yasuj University of Medical Sciences, Yasuj, Iran
2- Student Research center, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran
3- Department of Biostatistics and Epidemiology, School of Health and Nutrition Science, Yasuj University of Medical Sciences, Yasuj, Iran
4- Department of Obstetrics and Gynecology, School of Medicine, Yasuj University of Medical Sciences, Yasuj, Iran , p.eslamnik284@gmail.com
Abstract   (1243 Views)
Aims: In preterm delivery, uterine contractions begin prematurely and lead to the opening of the cervix. Nifedipine and Indomethacin drugs can help reduce contractions and delay childbirth.  However, there are contradictions regarding their effect on preterm birth and inflammatory factors. This study aimed to compare the effect of nifedipine and indomethacin on uterine contractions, CRP, and white blood cells in pregnant women with idiopathic preterm labor.
Material and Methods: This single-blind clinical trial was conducted on 68 eligible pregnant women hospitalized with premature labor pains in Imam Sajjad Yasuj Hospital in 2022 and randomly assigned to two groups. With tocography, the fixation contractions must have at least four contractions higher than 15mmHg. Before and 48h after interventions, the number and time of contractions, cervical dilatation, WBC, DIFF, and CRP tests were measured. Data were analyzed using SPSS 25 software.
Findings: Both interventions improved the number and time of contractions, CRP, and neutrophil. However, there were no significant differences in these variables between Nifedipine and Indomethacin groups. The study showed a statistically significant difference between groups in the number of eosinophils and monocytes after the intervention (p<0.05).
Conclusion: Nifedipine and Indomethacin improve the number and duration of contractions, CRP, monocytes, and neutrophils. Nifedipine causes more decrease in eosinophil levels than indomethacin.

 
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References
1. Kashanian M, Shirvani S, Sheikhansari N, Javanmanesh F. A comparative study on the efficacy of nifedipine and indomethacin for prevention of preterm birth as monotherapy and combination therapy: A randomized clinical trial. J Matern Fetal Neonatal Med. 2020;33(19):3215-20. [DOI:10.1080/14767058.2019.1570117]
2. Daglar H, Kirbas A, Kaya B, Kilincoglu F. The value of complete blood count parameters in predicting preterm delivery. Eur Rev Med Pharmacol Sci. 2016;20(5):801-5. [link]
3. Oskovi Kaplan ZA, Ozgu Erdinc AS. Prediction of preterm birth: Maternal characteristics, ultrasound markers, and biomarkers: An updated overview. J pregnancy. 2018;2018:8367571. [DOI:10.1155/2018/8367571]
4. Ali AE, Ibrahim SA, Ahmed MA, Kareem SF. Prediction of preterm delivery in pregnant women with threatened preterm labor using transvaginal ultrasound and neutrophils to lymphocytes ratio. Zagazig Univ Med J. 2020;26(4):556-65. [link]
5. Dağdeviren G, Aksoy M, Çelik ÖY, Keleş A, Çelen Ş, Çağlar AT. Nifedipine and indomethacin in preventing preterm labor under 32 gestational weeks. Gulhane Med J. 2022;64:79-83. [DOI:10.4274/gulhane.galenos.2021.81300]
6. Mansourghanaei M. Seasonal pattern of preterm birth. J Guilan Univ Med Sci. 2011;20(79):77-83. [Persian] [link]
7. Doni D, Paterlini G, Locatelli A, Arnoldi S, Magri MC, Bernasconi D, et al. Effects of antenatal indomethacin on ductus arteriosus early closure and on adverse outcomes in preterm neonates. J Matern Fetal Neonatal Med. 2020;33(4):645-50. [DOI:10.1080/14767058.2018.1499091]
8. Boğa Pekmezekmek A, Binokay US, Seçilmiş MA, Kumcu E, Şimşek E, Akillioğlu K, et al. Evaluating the teratogenicity of ritodrine and nifedipine using a frog embryo teratogenesis assay (FETAX). Drug Chem Toxicol. 2015;38(3):254-65. [DOI:10.3109/01480545.2014.947423]
9. Jamil M, Abid R, Basharat A. Transdermal nitro-glycerine Versus oral Nifedipine for acute tocolysis in preterm labour: A randomised controlled trial. J Soc Obstet Gynaecol Pakistan. 2020;10(1):26-9. [link]
10. van Vliet EOG, Nijman TAJ, Schuit E, Heida KY, Opmeer BC, Kok M, et al. Threatened preterm birth (APOSTEL III): A multicentre, randomised controlled trial. Lancet. 2016;387(10033):2117-24. [DOI:10.1016/S0140-6736(16)00548-1]
11. Patel SS, Ludmir J. Drugs for the treatment and prevention of preterm labor. Clin Perinatol. 2019;46(2):159-72. [DOI:10.1016/j.clp.2019.02.001]
12. Rovers JF, Thomissen IJ, Janssen LC, Lingius S, Wieland BV, Dieleman JP, et al. The relationship between antenatal indomethacin as a tocolytic drug and neonatal outcomes: A retrospective cohort study. J Matern Fetal Neonatal Med. 2021;34(18):2945-51. [DOI:10.1080/14767058.2019.1674807]
13. Hammers AL, Sanchez-Ramos L, Kaunitz AM. Antenatal exposure to indomethacin increases the risk of severe intraventricular hemorrhage, necrotizing enterocolitis, and periventricular leukomalacia: A systematic review with meta analysis. Am J Obstet Gynecol. 2015;212(4):505.e1-13. [DOI:10.1016/j.ajog.2014.10.1091]
14. Arbib N, Aviram A, Gabbay Ben-Ziv R, Sneh O, Yogev Y, Hadar E. The effect of labor and delivery on white blood cell count. J Matern Fetal Neonatal Med. 2016;29(18):2904-8. [DOI:10.3109/14767058.2015.1110572]
15. Lam MC, Hunt J, Anasti J. Neutophil to Lymphocyte Ratio: A Marker for Preterm Labor? [21R]. Obstet Gynecol. 2017;129(5):188S-9S. [DOI:10.1097/01.AOG.0000514165.93879.78]
16. Mestres Bazan EL. Los índices de neutrófilos/linfocitos y plaquetas/linfocitos como factores predictivos de parto prematuro en gestantes con amenaza de parto pretérmino en el Hospital Belén de Trujillo durante el periodo Enero 2015-Diciembre 2015. UPAO. 2017. [Spanish] [link]
17. Melissa C, Aaron H, Jonathan H, Angel G, James A. Neutrophil to lymphocyte ratio and red blood cell distribution width levels in preterm vs. term births. J Mol Genetic Med. 2018;12(317):1-12. [DOI:10.4172/1747-0862.1000317]
18. Forouzesh M, Sanagoo A, Vakili MA, Jouybari L. The effect of telenursing (telephone follow up) after discharge on readmission due to complications after coronary artery bypass graft surgery. Nurs Midwifery J. 2017;15(8):584-94. [Persian] [link]
19. Zhao F, Ai F, Wu J, Dong X. Changes and clinical significance of serum inflammatory factors in the treatment of pregnancy hypertension syndrome with magnesium sulfate combined with nifedipine. Exp Ther Med. 2020;20(2):1796-802. [DOI:10.3892/etm.2020.8863]
20. King JF. Tocolysis and preterm labour. Curr Opin Obstet Gynecol. 2004;16(6):459-63. [DOI:10.1097/00001703-200412000-00004]
21. Haas DM, Caldwell DM, Kirkpatrick P, McIntosh JJ, Welton NJ. Tocolytic therapy for preterm delivery: Systematic review and network meta-analysis. BMJ. 2012;345. [DOI:10.1136/bmj.e6226]
22. Kashanian M, Bahasadri S, Zolali B. Comparison of the efficacy and adverse effects of nifedipine and indomethacin for the treatment of preterm labor. Int J Gynecol Obstet. 2011;113(3):192-5. [DOI:10.1016/j.ijgo.2010.12.019]
23. Habib S, Sadaruddin S, Gill SY. Study to Determine the efficacy of nifedipine in inhibiting preterm labor. PJMHS.2020;14(4):1-3. [link]
24. Songthamwat S, Na Nan C, Songthamwat M. Effectiveness of nifedipine in threatened preterm labor: A randomized trial. Int J Women's Health. 2018;10:317-23. [DOI:10.2147/IJWH.S159062]
25. Carvajal JA, Zambrano MJ, Theodor NM, Moreno LE, Olguín TR, Vanhauwaert PS, et al. The synergic in vitro tocolytic effect of nifedipine plus ritodrine on human myometrial contractility. Reprod Sci. 2017;24(4):635-40. [DOI:10.1177/1933719116667221]
26. Rath W, Kehl S. Acute tocolysis-a critical analysis of evidence-based data. Geburtshilfe Frauenheilk. 2018;78(12):1245-55. [DOI:10.1055/a-0717-5329]
27. Huang S, Tian J, Liu C, Long Y, Cao D, Wei L, et al. Elevated C-reactive protein and complement C3 levels are associated with preterm birth: A nested case-control study in Chinese women. BMC Pregnancy Childbirth. 2020;20(1):131. [DOI:10.1186/s12884-020-2802-9]
28. Kim MA, Lee BS, Park YW, Seo K. Serum markers for prediction of spontaneous preterm delivery in preterm labour. Eur J Clin Invest. 2011;41(7):773-80. [DOI:10.1111/j.1365-2362.2011.02469.x]
29. Shahshahan Z, Iravani H. Comparison of CRP and ALK-P serum levels in prediction of preterm delivery. Adv Biomed Res. 2016;5:17. [DOI:10.4103/2277-9175.175903]