COMPARATIVE STUDY BETWEEN NICORANDIL AND NIFEDIPINE FOR THE TREATMENT OF PRIMIGRAVIDAS PRESENTING BY MODERATE PRETERM LABOR

Abstract

Objective: To compare the effectiveness of the potassium channel opener nicorandil with the calcium channel blocker nifedipine for tocolysis in moderate preterm labour in primigravidas. Methods: A randomized clinical trial of 230 pregnant women in preterm labour was conducted at Ain Shams University Hospital, Egypt. Eligible women were assigned at random into two groups: 115 women received nicorandil and 115 women received nifedipine. Prolongation of pregnancy for 48 hours was the primary outcome measure. Maternal and neonatal outcomes were also assessed. Results: Nicorandil was comparable to nifedipine for prolongation of pregnancy for 48 hours. Women treated with Nifedipine were significantly more likely to experience palpitation, hypotension, headache, nausea or vomiting and maternal tachycardia, (14.6%, 23.3%, 18.4%, 22.3% and 21.4% of cases, respectively) compared with women treated with nifedipine (p <0.001). No differences in neonatal outcome regardine NICU admission were observed between the two groups (P>0.05). Conclusions: Nicorandil is as effective as nifedipine for tocolysis in preterm labour with less maternal side effects, but unfortunately nicorandil is more expensive and not always available in Egyptian pharmacies. Larger studies are needed to assess safety and efficacy of Nicorandil as tocolysis in very preterm and in multiparous women.