A Comparative Study Of The Efficacy And Side Effects Of Isoxsuprine And Magnesium Sulphate In The Management Of Preterm Labour

ABSTRACT

Preterm labour, the most important single determinant of adverse infant outcome in terms of both survival and quality of life, is problematic because of the several neonatal complications and the long term sequelae. Preterm birth affects 12 – 18% of all births in India. Tocolytic therapy is the most commonly used strategy to arrest preterm labour. Isoxsuprine, a ß sympathomimetic agent is a drug that is currently used as a tocolytic but is associated with serious side effects. Magnesium sulphate is another Tocolytic which has also been the focus of recent research for its neuroprotective effects on preterm babies. We have compared the two in this study. Objectives: To compare the efficacy of Isoxsuprine with magnesium sulphate with respect to 1. Cessation of labour pains and prolongation of gestational age 2. Drug related side effects 3. The perinatal outcome Methodology: 50 patients who came to Jubilee Mission Medical College hospital with preterm labour from November 2012 to April 2014 were randomised into two groups of 25 each. Group I was given Isoxsuprine 90mg intravenously in 1000ml Ringer lactate solution at the rate of 0.05 – 0.20 mg/min. Group M was given magnesium sulphate, loading dose of 4gm diluted in 100ml normal saline intravenously, followed by a continuous infusion of 2gm/hr for at least 12 hours. The vitals, urine output and patellar reflex of the patients were monitored. Results: The mean number of days gained in utero in group I and group M were 30.88 ±21.24 and 27.26±18.79 days respectively. The percentage of NICU admissions in group I was 28% and group M was 28%. Maternal side effects were noted in 32% in group I and 20% in group M. Conclusion: Magnesium sulphate is comparable to Isoxsuprine in its efficacy in managing preterm labour with less maternal and neonatal side effect