Is Combination Therapy of Atosiban and Nifedipine More Effective in Preterm Labor than Each Drug Alone? A Prospective Study

Aim of the study: To evaluate the efficiency of using a combined therapy of atosiban, and nifedipine in preterm labor, versus using each drug separately. Study design: Prospective, case-control study. Patients and methods: 150 pregnant patients, presenting to the Obstetric department with symptoms of preterm labor were recruited in the study: Patients were randomly divided into 3 groups, each group comprised 50 patients. Group 1, were prescribed atosiban, IV (6.75 mg initial dose, 300 microg/min loading dose for 3 hours, 100 microg/min maintenance dose for 48-96 hours) Group 2 were prescribed nifedipine in a dose of 20 mg orally, followed by 20 mg orally after 30 minutes. If contractions persist, therapy can be continued with 20 mg orally every 3-8 hours for 48-72 hours with a maximum dose of 160 mg/d. After 72 hours, if maintenance is still required, long-acting nifedipine 30-60 mg daily can be used. Maximum dose was 40 mg in the first hour then maintenance dose of 10 mg every 4-6 h for 48 hrs: and Group 3 were prescribed both lines of treatment, simultaneously. The study outcome was set as, continuation of pregnancy for one week from the start of the treatment without delivery. Results: 28 patients improved in the atosiban group (56%), 30 patients improved in the nifedipine group (60%), and 43 patients improved from the combined group (86%). Paired sample statistics, shows, that there is no statistically significant results between both groups, (p=0.159), on the other hand, the comparison between each of the atosiban, and combined group, as well as between nifedipine alone and the combined group showed significant relationship, where p value was: 0.000. Conclusion: Combination of Atosiban, and nifedipine was shown to be more effective than using each drug separately in the treatment of preterm labor, in terms of postponing the labor for one week or more, with acceptable side effects.