CLINICAL COMPARISON OF ORAL NIFEDIPINE AND SUBCUTANEOUS TERBUTALINE FOR INITIAL TOCOLYSIS

In search of further ''first line'' alternatives for reducing prematur e uterine irritability and contractions, oral nifedipine, a type II di hydropyridine calcium channel blocking agent, was selected for a prosp ective randomized comparison trial with an established subcutaneous te rbutaline protocol. Patients without primary exclusion criteria for to colysis, with gestational ages between 20 and 35 weeks, were eligible for the study. In this report, data from 52 patients have been collate d and have undergone appropriate tests of significance (28 patients re ceiving nifedipine and 24 patients receiving terbutaline). Both agents were found to be highly effective for tocolysis, with a success rate of 68% for nifedipine and 71% for terbutaline. Although not statistica lly significant, a tendency toward a decrease in side effects was note d with nifedipine when compared with terbutaline. No deleterious mater nal or fetal side effects were reported. Based on these data, nifedipi ne, given as a one time, 30 mg oral dose, proved to be as effective as the subcutaneous terbutaline injection protocol.