Study the Suppression of Preterm Labor Using Human Chorionic Gonadotropin Hormone Compared with Magnesium Sulphate

Abstract

Preterm labor is known as delivery prior to 37 completed weeks of gestation. Because 10% of total labors are preterm and 70% of neonatal mortality is caused by this problem, preterm labor is a significant problem in obstetrics, pediatrics & midwifery. This study aims at comparing the efficacy as well as adverse effects profile of (human chorionic gonadotropin hormone and magnesium sulphate) in suppression of preterm labor. This study was designed as a prospective comparative randomized clinical trial done from 4th April to 1st September 2020. The study population included pregnant women with preterm labor, who were admitted to Salah Al Din General Hospital, in Tikrit city. Sixty two cases who consented (Informed written consent was obtained from all the patients) were randomly allocated to 2 different intervention groups, named A and B. Group A and B consisted of 30 and 32 pregnant women, respectively. All cases were admitted in labour room and baseline investigations were done. Group A: For patients of group A: received an intravenously loading dose of 4 g (1 g/min) Magnesium sulphate. A continual infusion of 2 g per 1 hr was then administrated. The infusion was continued until 12 h of uterine quiescence is done. Group B: (32 women), intramuscular injection Human Chorionic Gonadotropin was administered as an initial dose of 5000 IU. Half hourly assessment of uterine contractions, maternal vital signs, fetal heart rate monitoring was done. All of the patients were under monitoring in the hospital until 24 h of the end of drug infusion. Also, both of the groups received Betamethasone, 12 mg every 24 hr for 2 doses. Patients were under control until the end of pregnancy. It was foun that Delay of Labour for ≥21 day was higher among Human Chorionic Gonadotropin group (68.8%) than among MgSO4 group (60%), and delivery within <2 days was higher among HCG group (9.4%) than among MgSO4 group (6.7%). The mean duration in hours from time of start of treatment with Magnesium sulphate to the contraction suppression was (2.9±0.08) lower than of the HCG treatment group (3.11±0.13). The commonest side effect of MgSO4 was thirst (50%), hyperthermia (46.67), and head ache (30%), dizziness (30%), while there is no side effect among HCG group except single case complained of head ache (3.13%), It was concluded that magnesium sulphate is better than Human Chorionic Gonadotropin in stopping preterm labour with faster onset of action than Human Chorionic Gonadotropin but had side effects for mothers more than Human Chorionic Gonadotropin.