Single versus combination tocolytic regimen in the prevention of preterm births in women: a prospective cohort study

Our objective is to compare the efficacy of combination regimen (salbutamol and nifedipine) against single regimen (nifedipine alone) in preventing preterm births among women with preterm labor.

A total of 76 women with gestational age (GA) ranging from 24+0 to 35+6 weeks, who sought treatment for preterm labor with or without cervical dilatation, were recruited for the prospective cohort study. Of these, 38 (50%) had single tocolytic regimen and 38 (50%) had combination tocolytic regimen. The mean GAs at admission were similar for both groups at 31 weeks (±2.93) for Group 1 and 30.9 weeks (±2.88) for Group 2 (P=0.873). The mean GAs at delivery were 37.8 weeks (±1.98) for the single regimen and 36.2 weeks (±3.26) for the combined regimen (P=0.011). The mean tocolytic to delivery interval for the single regimen was longer at 6.74 weeks (±3.13) as compared with 5.21 weeks (±3.61) for the combination regimen (P<0.05). Those on the combination regimen complained of more adverse effects (P<0.001).

Our study results suggested that the use of nifedipine as a single tocolytic regimen is as effective as the combination regimen in the delay of preterm births and has much less side effects. Hence, we recommend the sole use of nifedipine for the management of preterm labor.