Progesterone versus magnesium sulfate in the management of preterm labour

Abstract

Preterm labour is the leading cause of prenatal and neonatal mortality morbidity and long term neurodevelopmental problems. Diverse treatments have been employed in past to suppress preterm labour. Magnesium sulfate is often used as first line in suppression of preterm labour. Side effect of this includes thirst, hyperthermia, headache, diplopia, respiratory depression and rare cases respiratory paralysis and arrest. We take a decision that compares the ability of magnesium sulfate with progesterone in suppression of preterm labour. In this randomized clinical trial, 132 cases were chosen from pregnant women between the 26 to 34 weeks of pregnancy who were suffering from preterm contractions of uterus with intact amniotic sac and cervical dilatation of less than 4 cm. These women had been referred to obstetric ward of Ali – Ebne – Abitalib hospital, Zahedan, during the year of 2008 to 2009 and randomly were divided into two equal groups (66 cases in each group). The results were analyzed by Chi-square and T-test with SPSS software. In first group, primarily 4 g of magnesium sulfate was infused. And then 10 g (2 g/h) was continued. In second group, progesterone used 200 mg vaginal suppository as single dose. Sixty six women in magnesium sulfate group in 58 cases (89%) suppressed delivery at least for 48 h. In second group, from 66 women 52 case (79%) suppressed delivery at least for 48 h. In this study, differentiation was not significant (p value = 0.161) in two group. 95% women in first group (magnesium sulfate) had side effects and 5% women progesterone group had involved with side effects. This finding shows that the ability of progesterone in suppression of preterm labour is similar to magnesium sulfate; however, maternal side effect of magnesium sulfate was 95% while it was not for progesterone. Key words: Progesterone, magnesium sulfate, preterm labour, tocolytic.