Efficacy of oral nifedipine as a tocolytic agent

Veena Bikkolli Teekappa Gowda, Madhubala Kalidoss


Background: Preterm birth is defined as birth at less than 37 weeks period of gestation, is the most important single determinant of adverse infant outcome in terms of both survival and quality of life. The need for tocolysis in terms of safety and efficacy is necessary to decrease perinatal mortality and morbidity in preterm labour. This study was aimed to evaluate the effectiveness of nifedipine as a tocolytic for inhibiting uterine contraction in threatened preterm labour.

Methods: It was a prospective, nonblinded, single centred, randomized control trial. This study included 100 cases of preterm labour admitted in department of obstetrics and gynaecology, KIMSH, Bangalore, who satisfied the inclusion and exclusion criteria and were administered with nifedipine tocolysis.

Results: 100 cases of preterm were evaluated for the prolongation of pregnancy for more than 48 hours. Prolongation of pregnancy till term was observed in 88% of the cases administered with nifedipine tocolysis. The mean gestational age in each group was 32.58±1.95 weeks. Nifedipine had very few side effects, namely tachycardia and headache and no changes in fetal heart rate.

Conclusions: In this study oral nifedipine was found to be efficacious in prolongation of pregnancy for more than 48 hours with the ease of oral administration and with minimal dose tocolytic effect was achieved. It had minimal maternal and neonatal side effects and eliminate the need for intensive maternal monitoring.



Nifedipine, Tocolytics, Preterm

Full Text:



Songthamwat S, Nan CN, Songthamwat M. Effectiveness of nifedipine in threatened preterm labor: a randomized trial. Int J Womens Health. 2018;10:317-23.

Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, et al. Global, regional, and national causes of child mortality in 2000-13,with projections to inform post-2015 priorities: an updated systematic analysis. Lancet. 2015;385(9966):430-40.

Jaju PB, Dhabadi B. Nifedipine vs Ritodrine for suppression of preterm laor. J Obstet Gynaecol India. 2011;61(5):534-7.

Beck S, Wojdyla D, Say L, Betran AP, Merialdi M, Requejo JH, et al. The worldwide incidence of preterm birth: a systematic review of maternal mortality and morbidity. Bull World Health Organ. 2010;88(1):31-8.

Conde-Agudelo A, Romero R, Kusanovic JP. Nifedipine in the management of preterm labor: a systematic review and meta-analysis. Am J Obstet Gynecol. 2011;204(2):134.

Pawar P, Pawar A. Nifedipine versus isoxsuprine for suppression of preterm labour-a comparative randomised study. 2020;9(9):384-91.

Vliet EOV, Schuit E, Heida KY, Opmeer BC, Kok M, Gyselaers W, et al. Nifedipine versus atosiban in the treatment of threatened preterm labour (assessment of perinatal outcome after specific tocolysis in early labour: APOSTEL III-trial). BMC Pregnancy Childbirth. 2014;14:93.

Hangekar PM, Karale A, Risbud N. Our experience of nifedipine as a tocolytic agent in preterm labor (24 weeks to 36 weeks 6 days). Int J Reprod Contracept Obstet Gynecol. 2017;6(2):636-9.

Haas D, Benjamin T, Sawyer R, Quinney S. Short-term tocolytics for preterm delivery-current perspectives. Int J Womens Health. 2014;6:343-9.

Adegoke AS, Fasuba OB. Comparing the effectiveness of two different dosage regimens of oral nifedipine in the treatment of preterm labour. Trop J Obstet Gynaecol. 2020;37(1):67-71.

King JF, Flenady VJ, Papatsonis DN, Dekker GA, Carbonne B. Calcium channel blockers for inhibiting preterm labour. Cochrane Database Syst Rev. 2003;(1):002255.

Papatsonis DNM, Geijn HPV, Adèr HJ, Lange FM, Bleker OP, Dekker GA. Nifedipine and ritodrine in the management of preterm labor: a randomized multicenter trial. Obstet Gynecol. 1997;90(2):230-4.

Nassar AH, Abu-Musa AA, Awwad J, Khalil A, Tabbara J, Usta IM. Two dose regimens of nifedipine for management of preterm labor: a randomized controlled trial. Am J Perinatol. 2009;26(8):575-81.