nifedipine for preterm labor administration

PROTOCOL: Tocolysis with Nifedipine Background: Nifedipine (Adalat) is a calcium-channel blocker that acts by relaxing smooth muscle. Its main use until now has been in the management of hypertension and angina. A common approach is to administer an initial loading dose of 20 mg orally, followed by Read "Calcium channel blockers for inhibiting preterm labour; a systematic review of the evidence and a protocol for administration of nifedipine, Australian and New Zealand Journal of Obstetrics and Gynaecology" on DeepDyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. Weerakul W, Chittacharoen A, Suthutvoravut S. Nifedipine versus terbutaline in management of preterm labor. We present the first case reported of a patient with preterm labor treated with nifedipine who had development of a concurrent elevation in serum liver enzyme levels. 5. Management of preterm labor: atosiban or nifedipine? Nifedipine blocks the slow calcium channels thus preventing the flow of calcium ions into the cell. Nifedipine may also be used for purposes not listed in this medication guide. Tocolysis may enable pregnancy prolongation, at least over the short term, and thus provide time for further in utero maturation and interventions that may improve infant outcome. 2003;43:192-198. 1-3 Nearly half of all preterm births are preceded by preterm labor, but preterm birth may also occur following membrane rupture or in the presence of other medical conditions. Nifedipine, a calcium channel blocker, has been used experimentally when other drugs fail to suppress uterine activity. Nifedipine 10-20mg orally, repeat in 30 mins prn; then 10-20mg q2-6h. The primary outcome was inhibition of preterm labor… Preterm labor leading to preterm birth is a significant cause of morbidity and mortality in infants. Labor is likely to be induced: When a complication develops such as hypertension, Preeclampsia, Heart Disease, Gestational Diabetes, or bleeding during pregnancy. If the baby is in danger of not getting enough nutrients and oxygen from the placenta. The amniotic sac has ruptured but labor hasn't started within 24-48 hours. More items... and nifedipine resulting in hypotension and neuromuscular blockade effects. ... Balasubramani SR, Kamatchi K. Transdermal nitroglycerin versus oral nifedipine administration for tocolysis in preterm labour. I take nifedipine. On February 17, 2011, the FDA notified healthcare professionals that terbutaline administered by injection or through an infusion pump should not be used in pregnant women for prevention or prolonged treatment (beyond 48 to 72 hours) of preterm labor in either the Some brand names for nifedipine are Procardia®, Adalat CC®, and Afeditab CR®. Nifedipine therapy for preterm labor: effects on placental, fetal cerebral and atrioventricular Doppler parameters in the first 48 hours S. GUCLU*, M. GOL*, U. SAYGILI*, N. DEMIR*, O. SEZER* and A. Maternal parameters studied were Gravida and Parity, previous history of preterm labor, gestational age at delivery, mode of delivery, side effects. In a randomized study with 206 threatened preterm labor patients, after 90 minutes of administration of nifedipine, 88.3% women of the nifedipine group had no uterine contractions (10). However, there is controversy about the best tocolytic therapy to be considered as the first choice. Tabulation, integration, and results … In practice, tocolytics such as nifedipine are commonly used to inhibit preterm labor in an attempt to delay delivery by at least 48 hours. However, high-quality evidence is lacking that any tocolytic is superior to placebo for reducing adverse neonatal outcomes following preterm labor. Dosing labetolol, nifedipine and hydralazine in pre-eclampsia. ials (RCTs) comparing atosiban with nifedipine directly, or either drug with betamimetics, in order to allow for indirect analyses. Nifedipine is in a group of drugs called calcium channel blockers. The high-pass filter was set at 100 Hz. A. BASCHAT† *Dokuz Eylul University School of Medicine, Department of Obstetrics and Gynecology, Izmir, Turkey and †Department of Obstetrics and Preterm birth, or the birth of an infant of less than 37 weeks’ gestation, is a leading cause of neonatal mortality in the United States. preterm labor cases were given Cap. One of the effective treatments for preterm labor is nifedipine, which is a calcium channel blocker and is associated with improvement in neonatal outcomes. Women with singleton pregnancies admitted in preterm labor (24 to 34 weeks) were randomized to high-dose (HD) nifedipine ( N = 49; 20 mg loading dose, repeated in 30 minutes, daily 120 to 160 mg slow-release nifedipine for 48 hours followed by 80 to 120 mg daily until 36 weeks) or low-dose (LD) nifedipine ( N = 53; 10 mg, up to four doses every 15 minutes, daily 60 to 80 mg slow-release nifedipine … In the United States, preterm delivery is the leading cause of neonatal morbidity and is the most common reason for hospitalization during pregnancy. Consequently, nifedipine has emerged as an effective and rather safe alternative tocolytic agent for the management of preterm labor after several studies have shown that the use of nifedipine in comparison with other tocolytics is associated with a more frequent successful prolongation of pregnancy, resulting in significantly fewer admissions of newborns to the neonatal intensive care unit, and is … J Evol Med Dent Sci 2017;6:3967-74. Materials and Methods: This randomized clinical trial was carried out on a total of women with PTL referring to Imam Reza Hospital … The purpose of tocolytic drug administration is to postpone threatening preterm delivery … PMID: 1497061 [Indexed for MEDLINE] Publication Types: Case Reports; MeSH terms. Researchers found that Nifedipine was more efficacious in halting preterm labor contractions than many other tocolytics used, most notably Magnesium Sulfate, a mainstay of preterm labor therapy. When used in preterm labor, it relaxes the uterine wall muscle, decreasing contractions and prolonging the time to delivery. The Sample technique was convenience (Non - Probability). Based on the American College of Obstetricians and Gynecologists (ACOG) guidelines for the management of preterm labor, calcium channel blockers, such as nifedipine, are an effective and recommended treatment option for the management of preterm labor to prolong pregnancy and allow for the administration of antenatal steroids [ACOG 171 2016]. A tocolytic agent such as nifedipine can delay the labor for over 48 hours (1). The World Health Organization has estimated that 12.9 million births, or 9.6% of all births worldwide, were preterm in 2005. Nifedipine belong to a group of medications called calcium channel blockers. Additionally, it was better tolerated by women who used it and women reported having fewer adverse reactions compared to the other medications. Hepatotoxicity with the administration of nifedipine for treatment of preterm labor George F. Sawaya, MD, and Patricia A. Robertson, MD San Francisco, California Nifedipine, a calcium channel blocker, is becoming increasingly popular as a tocolytic medication. 2011;36(9):HS-13-HS-16. Int J Gynaecol Obstet . Magnesium: (Major) Clinically significant drug interactions including neuromuscular blockade and hypotension have occurred when IV magnesium salts were given concurrently with nifedipine during the treatment of hypertension or premature labor during pregnancy. Tocolytic agents are medicines that are given to women in preterm labor to prolong pregnancy for at least 48 hours to enable administration of antenatal corticosteroids, magnesium sulfate, or buy a bit more time for maternal transport to a tertiary care facility. calcium-channel blocker that is used to slow or stop contractions of the uterus. King JT, Flenady V, et al.. Calcium channel blockers for inhibiting preterm labour; a systematic review of the evidence and a protocol for administration of nifedipine. Parameters measured was the cervical length before and after the administration of nifedipine and isoxsuprine. US Pharm. This is seldom reported in clinical practice (Snyder & Cardwell, 1989; Ben-Ami et al, 1994). METHODOLOGY: Pregnant women having preterm labor pain admitted through Consultant OPD were included and divided into 2 groups of 30 each, Group A was treated with Oral Nifedipine and Group B was treated with intravenous Salbutamol. Background: Preterm labor (PTL) is one of the most serious complications of pregnancy and major cause of mortality in neonates.The present study aimed to compare the effectiveness of nifedipine and transdermal nitroglycerin in the treatment of PTL. A … Women with a history of spontaneous preterm delivery … Fetal Doppler ultrasound was performed and fetal systolic and diastolic function was measured prior to, and 48 h after, the first nifedipine treatment. Calcium channel blockers (CCBs), commonly used to reduce blood pressure, can also be used to relax uterine contractions and postpone a preterm birth. Drug: Nifedipine 10 mg. For both groups, when preterm labor is diagnosed, 10 mg capsule will be given sublinguially and if it is not effective in 1 hour, the same dose will be repeated again, and the same regimen will be repeated every day till preterm labor ends or proceed to a preterm birth. Evaluation, monitoring and reporting of compliance to this guideline Adult 6. A total of 45 pregnant women who required nifedipine for preterm labor were included in this study. Methods of study selection A review was conducted of published, unpublished, and ongoing RCTs comparing atosiban with nifedipine directly, or either drug with betamimetics, in pregnant women under threat of preterm labor. Labetolol 20 mg IV then 20-80mg q20-30 mins to a maximum dose of 300mg or constant infusion 1-2mg/min IV to a target BP <160/110. To study the long-term effects of nifedipine administration, Doppler examinations were performed prior to nifedipine administration and at 12, 24, and 48 h after the first dose. Clinical diagnosis of preterm labor is made if there are regular contractions and concomitant cervical change. [Medline] . It is used to treat high blood pressure (hypertension) and chest pain (angina). But the use of tocolytics is controversial. Aust NZJ Obstet Gynaecol. Betamethasone for enhancing fetal lung maturity. Sometimes it is used to stop labor before 37 weeks of pregnancy (preterm delivery). The rate of preterm delivery (before 37 weeks' gestation) has been declining since 2007. Nifedipine: An optimal nifedipine dosing regimen for treatment of preterm labor has not been defined. 2002 Mar. The effects have been attributed to nifedipine potentiation of the neuromuscular blocking effects of magnesium. Nifedipine as tocolytic and Inj. 76(3):311-3. Neonatal parameters studied were weight at birth, APGAR score at birth, Objective: This study was undertaken to evaluate the efficacy of maintenance oral nifedipine in patients initially treated with intravenous magnesium sulfate for preterm labor.Study Design: Patients with a diagnosis of preterm labor between 24 and 33.9 weeks’ gestation were randomly assigned to receive either maintenance tocolytic therapy with oral nifedipine (20 mg every 4-6 hours) … Tocolytics are considered a standard treatment for women with threatened preterm delivery to allow time for maternal steroid administration and transfer to referral centers with neonatal intensive care units.

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