Comparative Study of Nifedipine and Terbutaline as Tocolytic Agents in the Management of Preterm Labour

The aim of this study was to compare the effectiveness, safety and possible adverse effects of terbutaline and nifedipine in prolonging pregnancy beyond 48 hrs. A randomized controlled trial was conducted with 60 pregnant women admitted with preterm labor, randomized into two groups, which were given terbutaline (30 patients) and nifedipine (30 patients) respectively. Bivariate and multivariate analysis, using regression, were used to analyze the data. No statistically significant difference was found between the two groups in terms of prolongation of gestation to 48 hrs. Both the drugs significantly prolonged the pregnancy (P < 0.001), however there was no statistically significant (P > 0.05) difference in the tocolytic efficacy (mean absolute prolongation of gestation) and birth outcomes between the two groups. The maximum number of patients in both groups (47 % in group A and 70 % in group B) delivered between 34.1 to 37 weeks. However, side effects were significantly more common in the terbutaline group (P < 0.02), especially maternal tachycardia, transient hypotension and chest pain. In the terbutaline group, 14.8 % neonates required mechanical ventilation while 11.1 % suffered intra ventricular hemorrhage. Terbutaline and nifedipine appeared to be equally effective in their tocolytic action. However, nifedipine did have the advantage of the ease of administration. It also had significantly less side effects.