• Ashish P Kalburgi Krishna Institute of Medical Sciences, Maharashtra, India
  • Nitin Kshirsagar Krishna Institute of Medical Sciences, Maharashtra, India




Oral Nifedipine, Transdermal, Nitroglycerin, Patch Tocolysis


Introduction: Preterm labour follows a spontaneous commencement of labour in two-thirds of preterm birth instances. Obstetricians must consider both treatment options for the management of preterm. The study was conducted to compare the tocolytic effects of oral nifedipine tablets and transdermal nitroglycerine patches in preterm labor.

Methodology: Cases with Singleton pregnancy, Pregnancy between 28 weeks to 36 completed weeks, and without contraindication for tocolysis were included in the study. Randomly assigned Nifedipine group received oral nifedipine (Tab Depin 10mg) and NTG group received transdermal nitroglycerine patch (Nitroderm 10). Progress was assessed for effect of drug for tocolysis.

Results: Both groups were comparable in terms of demographic variable, vital measures, bishop score and cervical dilatation at the time of reporting. Comparison of mean prolongation duration according to gestational age in both the study groups indicate that overall duration of prolongation was better in oral nifedipine. However, the differences were not statistically significant. Headache and hypotension were significantly higher in Nitroglycerine patch compared to oral nifedipine group. The treatment discontinuation was significantly higher in Nitroglycerine patch compared to oral Nifedipine.

Conclusion: Tocolytic effect of both, oral nifedipine and Nitroglycerine patch was statistically almost similar. However, considering the feasibility of application, availability, and cost of the drug, we recommend to use oral nifedipine for tocolysis over Nitroglycerine patch.


WHO. Preterm Birth. Available from: https://www.who.int/ news-room/fact-sheets/detail/preterm birth [Last accessed on 2022 Aug 22].

Gahlot K, Pandey K, Singh PP, Gahlot V, Mourya R. To evaluate diagnostic efficacy of maternal serum Creactive protein to predict preterm labour. Int J Reprod Contracept Obstet Gynecol. 2016;5:4001-4. Doi: https://doi.org/10.18203/2320-1770.ijrcog20163878

Arias F, Bhide AG, Arulkumaran S, Damania K, Daftary SN. 5th ed. Gurgaon, India: Elsevier, Private Limited; 2015. Practical Guide to High Risk Pregnancy and Delivery; pp. 204-6. [Google Scholar]

Balasubramani SR, Kamatchi K. Transdermal nitroglycerin versus oral nifedipine administration for tocolysis in pre-term labour. J Evol Med Dent Sci. 2017;6:3967- 74. Doi: https://doi.org/10.14260/Jemds/2017/859

Haram K, Mortensen JH, Morrison JC. Tocolysis for acute preterm labor: does anything work. J Matern Fetal Neona-tal Med. 2015;28(4):371-8. Doi: https://doi.org/10.3109/14767058.2014.918095 PMid:24990666

Robertson RM and Robertson D: Drugs used for the treat-ment of myocardial ischemia. In: Joel GH, Alfred Goodman Gilman, Lees EL (eds), Goodman and Gilman's the pharmacological basis of therapeutics. 9th edition, McGraw Hill. 1996; pp759- 779.

Sharma N, Rani S, Huria A, Chawla D. Oral nifedipine ver-sus nitroglycerine patch for tocolysis in preterm labour. Int J Reprod Contracept Obstet Gynecol 2019;8:174-8. Doi: https://doi.org/10.18203/2320-1770.ijrcog20185418

Hubinont C, Debieve F. Prevention of Preterm Labour: 2011 Update on Tocolysis. J Pregnancy. 2011 Nov 15;2011:941057. Doi: https://doi.org/10.1155/2011/941057 PMid:22175022 PMCid:PMC3228310

Banerjee BD, Mustafa MD, Sharma T, Tyagi V, Ahmed RS, Tripathi AK, Guleria K. Assessment of toxicogenomic risk factors in etiology of preterm delivery. Reprod Syst Sex Disord. 2014;3(2):1-0.

Rekha S, Pooja G, Shipra C, Reshu A. Clinical Evaluation of Transdermal Nitroglycerine in Preterm Labor in Tertiary Care Teaching Hospital in. Int J Sci Res Publ [Internet]. 2012;2(3):1-7.

Butler AS, Behrman RE, editors. Preterm birth: causes, consequences, and prevention. National Academies Press; 2007 May 23.

Amorim MMR, Lippo LAM, Costa AAR, Coutinho IC, Souza ASR. Transdermal nitroglycerin versus oral nifedipine ad-ministration for tocolysis: A randomized clinical trial. Rev Bras Ginecol e Obstet. 2009;31(11):552-8.

Dhawle A, Kalra J, Bagga R, Aggarwal N. Nifedipine versus nitroglycerin for acute tocolysis in preterm labour: a randomised controlled trial. Int J Reprod Contraception, Obstet Gynecol [Internet]. 2013;2(1):61-6. Doi: https://doi.org/10.5455/2320-1770.ijrcog20130211

Kashanian M, Zamen Z, Sheikhansari N. Comparison be-tween nitroglycerin dermal patch and nifedipine for treatment of preterm labor: A randomized clinical trial. J Perinatol. 2014;34(9):683-7. Doi: https://doi.org/10.1038/jp.2014.77 PMid:24811226

Kashanian M, Akbarian AR, Soltanzadeh M. Atosiban and nifedipin for the treatment of preterm labor. Int J Gynaecol Obstet. 2005;91:10-4. Doi: https://doi.org/10.1016/j.ijgo.2005.06.005 PMid:16043178

Kaur P, Madan A, Sharma S. A comparative study of trans-dermal nitroglycerine patch and oral nifedipine in preterm labor. Ann Afr Med. 2021 Jan-Mar;20(1):31-36. Doi: https://doi.org/10.4103/aam.aam_11_20 PMid:33727509 PMCid:PMC8102892

Papatsonis DN, Bos JM, van Geijn HP, Lok CA, Dekker GA. Nifedipine pharmacokinetics and plasma levels in the man-agement of preterm labor. Am J Ther. 2007;14:346-50. Doi: https://doi.org/10.1097/01.mjt.0000209679.76335.df PMid:17667209

Yasmin S, Sabir S, Zahoor FT. To compare the effective-ness of nifedipine and glyceryl trinitrate patch in prevention of preterm labour. J Postgrad Med Inst. 2016;30:92-6.

American College of Obstetricians and Gynecologists: Management of preterm labor. Practice Bulletin No.171. 2016;128(4).




How to Cite

Kalburgi, A. P. ., & Kshirsagar, N. . (2023). WHICH ONE IS BETTER FOR TOCOLYSIS IN PRE-TERM LABOR?: ORAL NIFEDIPINE VS TRANSDER-MAL NITROGLYCERIN PATCH. National Journal of Medical Research, 13(02), 50–58. https://doi.org/10.55489/njmr.13022023961



Original Research Articles