COMPARISON OF SALBUTAMOL AND NIFEDIPINE IN TREATMENT OF PRETERM LABOUR

Abstract

Introduction: Approximately 5–10% of pregnant women experience preterm labor (PTL), which is one of the leading causes of infant morbidity and mortality globally. Delaying delivery for at least 48 hours in order to provide prenatal corticosteroids is known as tocolysis. Salbutamol and nifedipine are two often given tocolytics, but there is currently a paucity of comparison data from Pakistan.

Objective: Using subgroup analysis based on BMI, compare the safety and efficacy of intravenous salbutamol with oral nifedipine in preventing premature labor.

Method: Prospective comparative analysis at JPMC Karachi’s gynecology ward. A total of 200 women experiencing preterm labor between 28 and 36+6 weeks of pregnancy were included in the trial; 100 participants were assigned to the nifedipine and salbutamol groups, respectively. The success rate of halting work for at least 48 hours was the main goal.

Result: Both tocolytic agents proved efficacious, with nifedipine demonstrating a successful response in 80% of cases, while salbutamol showed efficacy in 84% (p=0.721). The superiority of nifedipine in prolonging pregnancy duration up to a week beyond 48 hours is statistically significant (37.5% compared to 20.6%, p=0.03). Salbutamol-induced maternal adverse effects were found to be significantly more common than those caused by nifedipine (palpitations: 27.3% versus 5.0%, p<0.001). Increased BMI negatively correlated with efficacy for both drugs.

Conclusion: While nifedipine and salbutamol demonstrated comparable tocolytic efficacy in general, the former agent shows greater efficacy in extending pregnancy duration after 48 hours and provides a safer maternal profile. Nifedipine should therefore be regarded as a preferable choice for use in preterm labor induction.