H.C.G (Human Chorionic Gonadotropin) versus Magnesium sulphate in suppression of preterm labour
Abstract
Introduction: Preterm labour is a major healthcare problem throughout the world, it is a major cause of perinatal mortality and morbidity.
Methods: Prospective comparative study conducted in the Department of Obstetrics & Gynaecology at Kamla Raja Hospital, Gwalior, M.P, from August 2011 to September 2012. Sample Size: 80. 50 patients were given H.C.G. and 30 were given Magnesium sulphate to suppress preterm labour. Statistical analysis done using Chi square test in SPSS software and p value < 0.05 was considered significant.
Results: Mean duration between initiation of treatment & suppression of contractions was 3.1 hrs & 2.9 hrs in women receiving H.C.G. & Magnesium sulphate respectively (p value<0.0001). Mean prolongation of pregnancy was 31.4 days and 30.33 days in women receiving H.C.G. & Magnesium sulphate respectively (p value = 0.78). Average rate of labour within 48 hrs after beginning of treatment was 8% and 6.67%, in H.C.G. & Magnesium sulphate grp respectively, p value=0.43. None of the women receiving H.C.G. had any side effects, all 30 women receiving Magnesium sulphate had minor maternal side effects, p value (<0.0001). Mean birth weight was 2.35 kgs and 2.19 kgs respectively in women receiving H.C.G. and Magnesium sulphate reapectively, (p value = 0.22).
Conclusion: Magnesium sulphate is better tocolytic drug, showing statistically significant lesser time between the initiation of treatment & suppression of contractions, as compared to H.C.G. Women receiving Magnesium sulphate suffered from minor side effects; however those treated with H.C.G. had no complaints.
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References
2. Lockwood CJ. Calcium- channel blockers in the management of preterm labor. The Lancet 1997;350(9088);1339-1340. [PubMed]
3. Ticconi C, Piccione E, Belmonte A, Rao ChV. HCG- A new kid on the block in prematurity prevention. J Matern Fetal Neonatal Med 2006 Nov;19(11):687-92. [PubMed]
4. Slattery MM, Brennan C, O´Leary MJ, Morrison JJ. Human chorionic gonadotropin inhibition of pregnant human myometrial contractility. Br J Obstet Gynecol 2001 Jul;108(7):704-8. [PubMed]
5. Reshef F, Lei ZM, Rao Chv, Pridham DD, et al. The presence of gonadotropin receptors in non–Pregnant human uterus, human placenta, fetal membranes and deciduas. J Clin Endocrinol Metab 1999;70:421– 429. [PubMed]
6. Chegini M, Lei ZM, Rao CV, Hansel W. Cellular distribution and cycle phase dependency of gonadotropin and eicosanoid binding sites in bovine corpora lutea. Biol Repord 1991;45:506–13.
7. Edelstam G, Karlsson, C, Westgren M, Lowbeer C, Swahn ML. Human chorionic gonadotropin (hCG) during third trimester pregnancy. Scand J Clin Lab Invest 2007; 67(5):519-52. [PubMed]
8. Kathleen Parfitt, BSc, RF Pharma S, Martinadale. The complete drug Reference, 32 Ed. 1999; Part 1, 1-1539.
9. Bennett P, Edwards D, Use of magnesium sulphate in obstetrics. The Lancet 1997;350:1494.
10. Esmailpoor N, Shokrieh R. Magnesium Sulfate versus Placebo in treatment of preterm labor. J Medical Science of Gilan university, Iran 2001; 39:72-77.
11. Kathleen P, Martindale W. The complete drug reference 32th Ed, Binghamton: pharmaceutical Press; 1999: 893.
12. Elliott JP. Magnesium sulphate as a tocolytic agent. Am J Obst & Gynae 1983;142;277.
13. Doyle LW, Crowther CA, Middleton P, Marret S, Rouse D. Magnesium sulphate for women at risk of preterm birth for neuroprotection of the fetus. Cochrane Database Syst Rev. 2009 Jan;(1):CD004661.
14. Royal college of Obst & Gyn. Magnesium sulphate to prevent cerebral palsy following preterm birth, Scientific Advisory Committee Opinion Paper 29. London: RCOG Press; 2011.
15. Reshef F, Lei ZM, Rao Chv, Pridham DD, Chegini N, Luborsky JL. The presence of gonadotropin receptors in non–Pregnant human uterus, human placenta, fetal membranes and deciduas. J Clin Endocrinol Metab 1999;70:421– 309.
16. Toth P, Gimes G, Paulin F, Rao Ch V. HCG treatment in early gestation: its impact on uterine blood flow and pregnancy outcome. Fertil Steril 1998;70:s46.
17. Kurtzman JT, Spinnato JA, Goldsmith LJ, Zimmerman MJ, Klem M, Lei ZM, Rao CV. Human chorionic gonadotropin exhibits potent inhibition of preterm delivery in a small animal model. Am J Obstet Gynecol 1999;181:853-57.
18. Ali AFM, Fateen B, Ezzet A, Badawy H, Ramaan A, El-tobge A. Treatment of preterm labour with humanchorionic gonadotropin: anewmodality. BJOG 2000 Apr;95(4):S61.
19. Al-Saffar IY, Salih HI. Human chorionic gonadotropin in treatment of preterm labour. The Iraqi Postgraduate Medical Journal 2010;9(3): 288-292.
20. Sakhavar N, Mirteimoori M, Teimoori B. Magnesium Sulfate versus HCG (Human Chorionic Gonadotropin) in Suppression of Preterm Labor. Shiraz E-Medical Journal 2008 Jul;9(3):134-140.
21. Lorzadeh N, Kazemirad S, Lorzadrh M, Dehnori A. A comparison of human chorionic gonadotropin with Magnesium Sulphate in inhibition of preterm labour. J Med Sci 2007 May;7(4):640-644.