Nifedipine Alone or Combined with Sildenafil Citrate for Management of Threatened Preterm Labour

Background: Preterm labor (PTL) is defined as the delivery of a baby after twenty weeks of gestation and prior to the completion of thirty-seven weeks of gestation. Aim: To determine whether the tocolytic effect of nifedipine in combination with sildenafil citrate is more effective than nifedipine alone in the prevention of threatened preterm labor. Methods: This randomized controlled study was performed on sixty ladies attending Al Zahraa University Hospitals complaining of lower abdominal pain. They were categorized into two groups: Group I (30 cases) received nifedipine twenty milligrams (EPICO Company) orally (starting dose), subsequently followed by ten milligrams of sildenafil citrate administered orally every six to eight hours concurrently with vaginal administration. (twenty-five milligrams at eight-hourly intervals)Moreover, group II (30 patients) received nifedipine alone. Medications continued for forty-eight to seventy-two hours at the obstetrics and gynaecology department, Al-Azhar University, during the study duration from February 2021 to January 2023. Results: Both groups had a statistically insignificant variance in neonatal infection (13.3% vs 10%). The need for NICU admission was statistically significantly higher in infants who received nifedipine only than those who received nifedipine and Sildenafil (43.3% vs 30%). RDS was statistically significantly higher in infants who received nifedipine only than those who received nifedipine and Sildenafil (36.7% vs 13.3%). Conclusion: The combination of SC and nifedipine's tocolytic effect is more effective than nifedipine alone in enhancing perinatal results and inhibiting threatened PTL.