Comparison of the Eficacy of Intravenous Magnesium Sulfate and Oral Indomethcin in the Management of Preterm Labor

Background & Aims: Preterm labor is often resulted in preterm births and increased rate of neonatal morbidity and mortality. Treatment consists of bedrest, hydration, pharmacologic interventions, and combinations of these. The purpose of this study was to compare the efficacy of intravenous magnesium sulfate (MgSO۴) and indomethacin in the treatment of preterm labor pains. Neonatal and maternal side effects of each method were also studied. Methods: A total of ۱۲۰ women between ۲۶ and ۳۱ weeks’ gestation admitted due to preterm labor were randomized to receive either MgSO۴ (n = ۶۰) or oral indomethacin (n = ۶۰). All women received betamethasone and prophylactic antibiotics. Data were analyzed using student t-test and ۲. Results: The two groups had no significant difference in mean gestational age and cervical dilation and effacement at enrollment. The gestational age at delivery was similar in both groups (p=۰.۲۷۹). Delivery was delayed for more than ۴۸ hours in ۸۱% of subjects in MgSO۴ group and in ۸۷% of subjects in the indomethacin group (P=۰.۲۹۸). Neonatal birth weight, type of delivery, recurrent preterm labor pain and mean time to suppress the contractions were similar in both groups. No serious side effect was seen in the two groups. Conlusion: Acute tocolysis by either IV MgSO۴ or oral indomethacin can delay preterm birth for ۴۸ hours, provide the critical period of steroid effect, arrest an episode of preterm labor, and consequently delays delivery and improves neonatal outcomes. It is therefore necessary that all Obstetricians remain up-to-date regarding the efficacy, indications, contraindications, and side effects of all tocolytics.

Keywords:

Preterm Labor , magnesium sulfate , indomethacin , Tocolysis