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Corresponding Author

Marwan, Osama

Document Type

Original Article

Abstract

Background: The leading cause of neonatal and maternal morbidity is preterm delivery. Relevant hospitalization rates during pregnancy have been declining since 2007. Aim of the study: comparing the effects of nifedipine, ritodrine, and Indomethacin tocolytic drugs on Doppler parameters of the foetal umbilical and middle cerebral arteries in instances of preterm labour in order to choose the safest and most effective drug. Patients and Methods: In a cohort study, 132 patients with preterm labour symptoms, intact membranes, and a singleton gestation between 28 and 34 weeks of pregnancy were divided into three groups and admitted to the Obstetric Department at Ahmad Maher Teaching Hospital between May 2020 and October 2021. Results: Nifedipine and Ritodrine caused an increase in the maternal heart rate and fetal heart rate, but a statistically significant only in the ritodrine group. With a p-value less than 0.05, the ritodrine group had greater maternal tachycardia, palpitation, and dyspnea. The three drugs caused cessation of uterine contractions; however, was more in the nifedipine group. The three drugs showed a statistically non-significant difference in fetal umbilical artery PI and cerebroplacental ratio changes before and after treatment. The middle cerebral artery PI following therapy in the ritodrine and indomethacin groups was statistically non-significant, whereas the nifedipine group showed a statistically significant decrease with a P value of 0.027. Conclusion: The pulsatility index (PI) of the umbilical and middle cerebral arteries was not clinically significant in a foetal Doppler study, ensuring the medications' safety in both the mother and fetus aspects.

Keywords

Nifedipine; Ritodrine; indomethacin therapy; Fetal Umbilical; middle cerebral arteries

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