A clinical trial was performed to evaluate the tocolytic possibility of nifedipin and to propose a treatment regimen for preterm labor in the National Hospital of Gynecol-Obstet from July 2003 to December 2003. There were 40 cases of preterm labor with gestational age 31 weeks and 3 uterine contractions per minute on average. Patients received a 10 mg sublingual loading dose every 20 minutes (maximum dose 40mg), and followed by 20 mg oral dose every 6- 8 hours. Result: the effectiveness in tocolysis of nifedipin is very fast. It took 60-80 minutes to arrest uterine contraction (70- 80%) (including contractions of high frequency and intensity), especially in urgent tocolysis. The lower the frequency and intensity is, the higher and sooner the effectiveness is. 92.5% of delivery were delayed for 48 hours. 82.85% were postponed until 36 weeks, and the mean time of prolonged pregnacy was 39 days. Side-effects were mild and transient and in normotensive pregnant women blood pressure was almost unaffected. This treatment regimen of nifedipin showed the effectiveness in preterm labor. In brief, nifedipin is an effective, safe, convenient and economic tocolytic agent. It may well represent the best suitable tocolytic alternative currently available and can be used widely in Viet Nam.
Obstetric Labor, Premature, Nifedipine, Tocolysis

Premature labor remains one of the most intractable risk factors that contribute to perinatal morbidity and mortality. Tocolytics, antibiotics and corticosteroid have been used as the typical management for preterm labor. Various treatment of women with signs and symptoms of preterm labor has failed to decrease in the incidence of preterm births in the world. The management of preterm labor remains very controversial problems today. There are no clear "first-line" tocolytic drugs and antibiotics to prolong gestation period and improve perinatal outcome. But in Royal College of Obstetricians and gynecologists (RCOG) recommend that atosiban and nifedipine appear to be preferable as they have fewer side effects and seem to comparable effectiveness. So far there is insufficient evidence for any firm conclusions about whether or not maintenance tocolytic therapy following preterm labor is valuable. In conclusion, clinical circumstances and physician preferences should dictate treatment. Individual approach or combined treatment for preterm labor may be helpful in determining which treatment is suitable to each patient.
Anti-Bacterial Agents ; Female ; Humans ; Incidence ; Mortality ; Nifedipine ; Obstetric Labor, Premature* ; Pregnancy ; Premature Birth ; Risk Factors ; Tocolysis ; Tocolytic Agents

OBJECTIVES: The aim of this study was to compare the efficacy and safety of magnesium sulfate, ritodrine hydrochloride and nifedipine in the management of preterm labor. MATERIALS AND METHODS: 180 women with documented preterm labor were randomly assigned to receive magnesium sulfate (n=60), ritodrine hydrochloride (n=60) and nifedipine (n=60) as initial tocolytic therapy. 30 women with documented preterm labor were allocated to administer fluid only and bed rest as control group. Patient could be switched to another tocolytic regimen if they continued to have contractions or side effects. The main outcome variables examined were days gain in utero, success rate, side effects and neonatal outcome. RESULTS: There were no significant differences in maternal characteristics between the groups. The days gain in utero was no statistically different in the three groups(magnesium sulfate, ritodrine hydrochloride and nifedipine) but markedly longer in the three groups than the control group (p<.01). The total success rate was similar in the three groups, but side effects were much more in the magnesium sulfate and ritodrine group than the nifedipine group (p<.05). The respiratory distress syndrome in neonate was decreased in the three groups than the control group without statistical significance. CONCLUSION: Nifedipine is an effective, safe, and well-tolerated tocolytic agent. In this retrospective study, total success rate of controlling preterm labor was similar in the three groups, but patients who received nifedipine were less side effects than magnesium sulfate or ritodrine group.
Bed Rest ; Female ; Humans ; Infant, Newborn ; Magnesium Sulfate ; Magnesium* ; Nifedipine ; Obstetric Labor, Premature* ; Pregnancy ; Retrospective Studies ; Ritodrine* ; Tocolysis