The preterm labor causes 30% of all preterm births. The preterm birth occurs in about 11% of all pregnancies. It accounts for major neonatal mortality and morbidity. WHO defined the preterm labor, as the onset of labor prior to the completion of 37 weeks of gestation, in a pregnancy beyond 20 weeks of gestation.
This Research Article is an attempt to study the efficacy of Tablet Isoxsuprine as a tocolytic agent in the treatment of preterm labor 10mg versus 40mg regarding beneficial effect of prolonging pregnancy, neonatal outcome, the incidence of neonatal mortality and adverse effects.
Aim: The purpose of this study is to compare the effectiveness in the use of tablet Isoxsuprine hydrochloride as a tocolytic agent in the treatment of preterm labor 40mg vs. 10mg oral route and thereby evaluate its beneficial effect regarding
1. Prolonging the pregnancy
2. Neonatal outcome
3. Perinatal mortality and morbidity.
4. Maternal adverse effects.
Materials & Methods
Study design: It is a prospective comparative study. The study was conducted in Institute of social obstetrics ISO Government Kasturba Gandhi hospital for women and children-Triplicane from Dec 2011 to Dec 2012. The study population comprised of patients who were admitted either through casuality or OPD, who comes with complaints of preterm labour. Two groups of patients were selected randomly of which one group of patients were treated with 10mg of Tablet Isoxsuprine twice a day.
The next group of patients were treated with 40mg of Tablet Isoxsuprine as once a day. All patients were closely monitored for the adverse reactions of the drug and Foetal surveillance by biophysical profile. All the patients who were in the study received intramuscular dose of betamethasone for lung maturity and to prevent other neonatal complications like, respiratory distress syndrome, necrotizing enterocolitis. Written informed consent was obtained from all the patients under the study.
Results: There was no age related significant difference, in patients with preterm labour. The mean age is 25. P value < 0.393 which indicates no significant difference
In primi 50% received 10mg Tablet Isoxsuprine and another 50% received 40mg. Among the muti gravida 66.7% received 10 mg and 33.3% received 40mg. P-value is -0.061 (>0.05) which indicate no statistically significant difference. There is no siginificant risk factors noted.
Adverse effects were very minimum and can be reversed by withdrawing the drug. No significant different in adverse effects noted between 10mg and 40mg of Tablet Isoxsuprine.
Conclusion: The maternal side effects like headache more common in 40mg of Tablet Isoxsuprine and nausea and vomiting more common in 10mg of Tablet Isoxsuprine.
The incidence of Foetal mortality, morbidity was due to complications of prematurity of baby and not by the Tablet Isoxsuprine and its dosage.
However, early identification of risk factors, better antenatal care, treat the correctable causes, improving the socio-economic standards, early detection and intervention reduce the incidence of preterm labour.