Nifedipine Versus Magnesium Sulfate for Prevention of Preterm Labor in Symptomatic Placenta Previa

Oral Nifedipine Versus Intravenous Magnesium Sulfate for Prevention of Preterm Labor in Symptomatic Placenta Previa: Randomized Controlled Trial.

Antepartum hemorrhage is defined as bleeding from or within the female genital tract, occurring from 28+0 weeks of pregnancy and till delivery of the fetus. it occurs in 3-5% of pregnancies and is an important cause of perinatal and maternal morbidity and mortality worldwide

There are many tocolytic agents may have a role in conservative management of placenta previa such as magnesium sulfate, calcium channel blockers and β-sympathormimetics. In 2004 Sharma suggests that ritodrine hydrochloride in patients with symptomatic placenta previa tends to prolong the pregnancy and result in an increase in birth weight of the babies without causing any adverse effect on the mother and fetus

Inclusion Criteria:

• Estimated gestational age : between 28 weeks and 37 week's gestation
• Confirmed Placenta previa; either major or minor degrees.
• Placenta previa with preterm uterine contractions

Exclusion Criteria:

• Severe attack of bleeding requiring an immediate intervention.
• Fetal heart rates instability or non-reassuring tracing
• Intrauterine fetal death or major fetal anomalies.
• If associated with abruptio placentae
• Patients with known bleeding disorders or on anticoagulant therapy
• Patients with severe medical disorders as myasthenia gravis documented magnesium toxicity.