THE RELATIONSHIP BETWEEN USING NIFEDIPINE AND POSTPARTUM HEMORRHAGE IN PATIENTS WITH PRETERM LABOR

Ayman Sobhi Branbo*, PhD. Saoura Naisah and PhD. Sahar Hasan

ABSTRACT

Objective: To evaluate the risk of postpartum hemorrhage in patients treated with Nifedipine for the treatment of preterm labor. Methods: A prospective cohort study was conducted with 68 pregnant women admitted for preterm labor. One group of women was given Nifedipine to give time for the administration of corticosteroids for fetal lung maturity and/or control of preterm labor and another group was not given Nifedipine as they were admitted in advanced stage of labor (ie, more than or equal to 4 cm cervical dilatation). Independent/paired sample t-test, Mann-Whitney U test and Fisher’s exact test were used to determine the difference of mean, median, and frequency between and within groups, respectively. MINITAB 22. Was used for data analysis. Results: There was more blood loss during delivery, which was statistically significant, among those who received Nifedipine compared to those who have not taken the medicine (350 mL versus 265 mL, p = 0.002). Furthermore, the decreases in hemoglobin and hematocrit were also lower among those who did not receive Nifedipine compared to those who received Nifedipine for tocolysis (1.5 g/dL versus 1.2 g/dL, p = 0.014 and 0.045 versus 0.03, p = 0.002), again, statistically significant. The need for additional uterine tonics was higher in those who received Nifedipine treatment compared to those who did not, with a statistically significant difference (26 women who used Nifedipine versus 12 women who did not use it, p-value=0.006). Conclusion: Nifedipine used as tocolytic showed increase hemorrhage during delivery, which was statistically significant. Greater amount of blood loss may be anticipated among those with Nifedipine intake thus helping the obstetrician in preparing for active management of postpartum hemorrhage and preventing maternal complication.

Keywords: Nifedipine, preterm birth, postpartum Hemorrhage.