Human Chorionic Gonadotropin vs. Magnesium Sulfate (MgSO4) as a Tocolytic Agent: A Randomized Controlled Trial

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Pharmacology

Background:

• Preterm labor is a significant cause of neonatal morbidity and mortality.
• Tocolytic agents are used to suppress uterine contractions and prolong pregnancy.
• Magnesium sulfate (MgSO4) is a commonly used tocolytic, but its efficacy and side effect profile are debated.

Purpose of the Study:

• To compare the efficacy of β-human chorionic gonadotropin (HCG) with magnesium sulfate (MgSO4) as a tocolytic agent in preterm labor.
• To evaluate patient satisfaction, tocolysis failure rates, and maternal/neonatal outcomes.
• To assess the incidence of side effects and cesarean section rates associated with each agent.

Main Methods:

• A randomized controlled trial (NCT05828966) involving 70 patients with established preterm labor.
• Patients were randomized to receive either intramuscular HCG or intravenous MgSO4.
• Uterine contractions, maternal vital signs, and fetal heart rate were monitored half-hourly.

Main Results:

• HCG demonstrated significantly higher patient satisfaction and lower tocolysis failure rates within 48 hours compared to MgSO4 (P < 0.001).
• The HCG group experienced a lower incidence of preterm labor and fewer side effects (P = 0.010).
• Cesarean section rates were significantly higher in the MgSO4 group (P = 0.025).

Conclusions:

• HCG is a more effective tocolytic agent than MgSO4 for preventing preterm labor within the critical first 48 hours.
• HCG treatment is associated with superior efficacy, improved patient satisfaction, and a better safety profile.
• HCG offers potent tocolysis with minimal maternal and neonatal side effects, making it a promising alternative for preterm labor management.