{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T05:06:25Z","timestamp":1737522385681,"version":"3.33.0"},"reference-count":21,"publisher":"Knowledge E DMCC","issue":"5","content-domain":{"domain":["knepublishing.com"],"crossmark-restriction":true},"short-container-title":["IJRM"],"abstract":"<jats:p>Background: Preterm labor is one of the main causes of neonatal mortality and its treatment is still challenging.\r\nObjective: The study aimed to compare the effectiveness of nifedipine (Nif) with and without sildenafil citrate (SC) for the treatment of preterm labor in pregnant women.\r\n Materials and Methods: In this clinical trial study, 126 pregnant women referred to the Fatemieh hospital, Hamadan, Iran with a complaint of preterm labor were evaluated. Participants were randomly divided into 2 groups of Nif 20 mg orally (single dose), then 10 mg every 6-hr, and at the same time vaginal SC 25 mg every 8 hr (Nif + SC) or Nif alone. Treatment was continued for 48-72 hr if uterine contractions did not resolve in both groups. Delivery rates at the time of hospitalization and neonatal outcome were compared between the 2 groups.\r\nResults: No statistically significant difference was observed between the 2 study groups in terms of mean age, gestational age, body mass index, and parity. 76.2% of Nif + SC participants in the first 72 hr of hospitalization and 57.2% of Nif participants remained without delivery (p = 0.02). The neonatal hospitalization rate of the Nif + SC group in the neonatal intensive care unit was 25.4% and in the Nif group was 42.9% (p = 0.03).\r\nConclusion: Nif with SC is superior to Nif alone in women at risk of preterm labor due to increasing gestational age and better neonatal outcomes.\r\nKey words: Nifedipine, preterm labor, Sildenafil citrate, Randomized trial.<\/jats:p>","DOI":"10.18502\/ijrm.v21i5.13471","type":"journal-article","created":{"date-parts":[[2023,6,12]],"date-time":"2023-06-12T08:12:08Z","timestamp":1686557528000},"page":"379-386","update-policy":"https:\/\/doi.org\/10.18502\/knecrossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of nifedipine with and without sildenafil citrate for the management of preterm labor in pregnant women: A randomized clinical trial"],"prefix":"10.18502","volume":"21","author":[{"given":"Shahla","family":"Nasrolahei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyedeh Arezoo","family":"Hoseini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyedeh Azadeh","family":"Hosseini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyedeh Narjes Khatoon","family":"Hosseini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seyedeh Sahar","family":"Hosseini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Parsa Moradian","family":"Lotfi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"7770","published-online":{"date-parts":[[2023,6,10]]},"reference":[{"key":"243519","doi-asserted-by":"crossref","unstructured":"Suff N, Story L, Shennan A. The prediction of preterm delivery: What is new? Semin Fetal Neonatal Med 2019; 24: 27\u201332.","DOI":"10.1016\/j.siny.2018.09.006"},{"key":"243520","unstructured":"Jacobsson B, Pettersson K, Modzelewska D, Abrahamsson T, Bergman L, Hakansson S. [Preterm delivery: An overview on epidemiology, pathophysiology and consequences for the individual and the society]. Lakartidningen 2019; 116: FR6F. (in Swedish)"},{"key":"243521","doi-asserted-by":"crossref","unstructured":"Fritz T, Kallen K, Marsal K, Jacobsson B. Outcome of extremely preterm infants after iatrogenic or spontaneous birth. Acta Obstet Gynecol Scand 2018; 97: 1388\u20131395.","DOI":"10.1111\/aogs.13387"},{"key":"243522","doi-asserted-by":"crossref","unstructured":"Sebastian E, Bykersma C, Eggleston A, Eddy KE, Chim ST, Zahroh RI, et al. Cost-effectiveness of antenatal corticosteroids and tocolytic agents in the management of preterm birth: A systematic review. EClinicalMedicine 2022; 49: 101496.","DOI":"10.1016\/j.eclinm.2022.101496"},{"key":"243523","doi-asserted-by":"crossref","unstructured":"Patel SS, Ludmir J. Drugs for the treatment and prevention of preterm labor. Clin Perinatol 2019; 46: 159\u2013172.","DOI":"10.1016\/j.clp.2019.02.001"},{"key":"243524","doi-asserted-by":"crossref","unstructured":"Lamont RF, Jorgensen JS. Safety and efficacy of tocolytics for the treatment of spontaneous preterm labour. Curr Pharm Des 2019; 25: 577\u2013592.","DOI":"10.2174\/1381612825666190329124214"},{"key":"243525","doi-asserted-by":"crossref","unstructured":"Ferreira RS, Negrini R, Bernardo WM, Simoes R, Piato S. The effects of sildenafil in maternal and fetal outcomes in pregnancy: A systematic review and meta-analysis. PLoS One 2019; 14: e0219732.","DOI":"10.1371\/journal.pone.0219732"},{"key":"243526","doi-asserted-by":"crossref","unstructured":"Ala M, MohammadJafari R, Dehpour AR. Sildenafil beyond erectile dysfunction and pulmonary arterial hypertension: Thinking about new indications. Fundam Clin Pharmacol 2021; 35: 235\u2013259.","DOI":"10.1111\/fcp.12633"},{"key":"243527","doi-asserted-by":"crossref","unstructured":"Mohammadi E, Noei Teymoordash S, Norouzi AR, Norouzi F, Norouzi HR. Comparison of the effect of nifedipine alone and the combination of nifedipine and sildenafil in delaying preterm labor: A randomized clinical trial. J Family Reprod Health 2021; 15: 112\u2013117.","DOI":"10.18502\/jfrh.v15i2.6452"},{"key":"243528","doi-asserted-by":"crossref","unstructured":"Mokhtari G, Hamidi Madani A, Kazemnezhad Leyli E, Jafari A. Sildenafil citrate effects on seminal parameters in male participants with idiopathic infertility; A randomized, double-blind, controlled cross-over clinical trial study. Urol Sci 2022; 33: 93\u201398.","DOI":"10.4103\/UROS.UROS_113_21"},{"key":"243529","doi-asserted-by":"crossref","unstructured":"Hanley M, Sayres L, Reiff ES, Wood A, Grotegut CA, Kuller JA. Tocolysis: A review of the literature. Obstet Gynecol Surv 2019; 74: 50\u201355.","DOI":"10.1097\/OGX.0000000000000635"},{"key":"243530","doi-asserted-by":"crossref","unstructured":"Kashanian M, Shirvani Sh, Sheikhansari N, Javanmanesh F. A comparative study on the efficacy of nifedipine and indomethacin for prevention of preterm birth as monotherapy and combination therapy: A randomized clinical trial. J Matern Fetal Neonatal Med 2020; 33: 3215\u20133220.","DOI":"10.1080\/14767058.2019.1570117"},{"key":"243531","doi-asserted-by":"crossref","unstructured":"Ibrahim MH, Elfaki T, Elhassan EM, Abdelrahiem SK, Adam I. The effectiveness of nifedipine\/indomethacin combination therapy and nifedipine monotherapy for postponing preterm birth (25\u201334 weeks of gestation) in Sudanese women: A randomized clinical trial study protocol. BMC Pregnancy Childbirth 2021; 21: 457.","DOI":"10.1186\/s12884-021-03951-x"},{"key":"243532","doi-asserted-by":"crossref","unstructured":"van Winden TMS, Nijman TAJ, Kleinrouweler CE, Salim R, Kashanian M, Al-Omari WR, et al. Tocolysis with nifedipine versus atosiban and perinatal outcome: An individual participant data meta-analysis. BMC Pregnancy Childbirth 2022; 22: 567.","DOI":"10.1186\/s12884-022-04854-1"},{"key":"243533","doi-asserted-by":"crossref","unstructured":"Conde-Agudelo A, Romero R, Kusanovic JP. Nifedipine in the management of preterm labor: A systematic review and metaanalysis. Am J Obstet Gynecol 2011; 204: 134. e1\u201320.","DOI":"10.1016\/j.ajog.2010.11.038"},{"key":"243534","unstructured":"Lotfalizadeh M, Teymoori M. [Comparison of nifedipine and magnesium sulfate in the treatment of Preterm]. Iran J Obstet Gynecol Infertil 2010; 13: 7\u201312. (In Persian)"},{"key":"243535","unstructured":"Nikbakht R, Taheri Moghadam M, Ghane\u2019ee H. Nifedipine compared to magnesium sulfate for treating preterm labor: A randomized clinical trial. Iran J Reprod Med 2014; 12: 145\u2013150."},{"key":"243536","doi-asserted-by":"crossref","unstructured":"Abd El-Ghader AN, Ali AE-N, Abdallah KhM, Abdelhamid A. Sildenafil citrate versus nifedipine and dydrogesreone in prevention of preterm labor with short cervix. J Obstet Gynecol Reprod Sci 2018; 2.","DOI":"10.31579\/2578-8965\/009"},{"key":"243537","doi-asserted-by":"crossref","unstructured":"Turner J, Dunn L, Tarnow-Mordi W, Flatley C, Flenady V, Kumar S. Safety and efficacy of sildenafil citrate to reduce operative birth for intrapartum fetal compromise at term: A phase 2 randomized controlled trial. 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