Gynecology & Obstetrics
Open Access

Abstract

Efficacy and Safety of Progesterone versus Magnesium Sulfate in the Management of Preterm Labor: A Randomized Study

Batool Teimoori, Nahid Sakhavar, Masoome Mirteimoori, Behzad Narouie, Mohammad Ghasemi-rad, Mehrnaz Sarooneh-rigi and Shahin Navvabi-rigi

Introduction: Preterm labor is the leading cause of prenatal and neonatal mortality morbidity and long term neurodevelopmental problems.so that different treatments have been employed in order to suppress preterm labor from several years ago. Magnesium sulfate is often used as first line in suppressing of preterm labor. Side effect of this : thirst, hyperthermia, headache, diplopia, respiratory depression and rare cases respiratory paralysis and arrest.In later pregnancy progesterone may be important in maintaining uterine quiescence by limiting the production of stimulatory prostaglandins and inhibiting the expression of contraction – associated protein genes with in the myometrium natural progesterone administrated vaginally is considered is effective in suppression of preterm birth and safe for both mother and fetus. We take a decision that compare the ability of magnesium sulfate with progesterone in suppression of preterm labor.

Methods: In this randomized clinical trial 132 cases were chosen form pregnant women between the 26-34 weeks of pregnancy who were suffering from preterm contractions of uterus with intact amniotic sac and cervical dilatation of less than 4cm.these women had referred to obstetric ward of Ali – Ebne – Abitalib hospital, Zahedan, during the years of 2008-9 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.

Results: In first group primarily 4 grams of magnesium sulfate infused. And then 10 grams (2grams per hours) was continued.in second group progesterone used 200 mg vaginal suppository as single dose.in first group delivery during 48 hour was failure of treatment and second group if no controlled contraction of uterus after 1 hour, changed to magnesium sulfate and this case was failured. From 66 women in magnesium sulfate group in 58 case (89%) suppressed delivery at least for 48 hours.In second group from 66 women 52 case (79%) suppressed delivery at least for 48 hours.in this study differentiation was no significant (p value=0.161) in two group. 95 percent women in first group (magnesium sulfate) had side effects and 5 percent women progesterone group had involved with side effects.

Conclusion: This finding show the ability of progesterone in suppression of preterm labor is similar to magnesium sulfate however maternal side effect of magnesium sulfate was 95% while it was no for progesterone.