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Larger studies with different dosage regimens, probably multicentre, are needed to confirm our findings and gain a better understanding of the mechanism of action of this novel therapeutic intervention.None declared. The study was also registered at ClinicalTrials.gov (Recruitment started on 28 January 2015 and ended in November 2016 for cases of threatened PTL with a singleton pregnancy between 24 and 34 weeks’ gestation, irrespective of whether the patient had a previous history of PTL. Each envelope contained an assignment for a single patient. 19 This review concluded that, when … The review was generally well conducted, but the authors’ conclusions regarding magnesium sulphate may be too strong … Management of preterm laborNational Institute for Health and Clinical ExcellenceA core outcome set for evaluation of interventions to prevent preterm birthGlobal report on preterm birth and stillbirth (1 of 7); definitions, description of the burden and opportunities to improve dataMagnesium sulphate compared with nifedipine for acute tocolysis of preterm laborAn L‐arginine‐nitric oxide‐cyclic guanosine monophosphate system exists in the uterus and inhibits contractility during pregnancyReorganization of myofilament proteins and decreased c‐GMP dependent protein kinase in the human uterus during pregnancyNitric oxide stimulation of cGMP accumulation in myometrial cells from pregnant women is antagonized by oxytocinDoes sildenafil citrate affect myometrial contractile response to nifedipine in vitro?Relaxant action of sildenafil citrate (Viagra) on human myometrium of pregnancySildenafil (Viagra) prolongs cardiac repolarization by blocking the rapid component of the delayed rectifier potassium currentSildenafil in pregnancy: a systematic review of maternal tolerance and obstetric and perinatal outcomesSildenafil citrate in the treatment of pain in primary dysmenorrhea: a randomized controlled trialNovel biopharmaceutical use of sildenafil citrate in treatment of unexplained recurrent miscarriage: first longitudinal clinical study of 50 cases from EgyptA systematic review of experimental and clinical studies of sildenafil citrate for intrauterine growth restriction and pre‐term labourStudy of effect of sildenafil citrate in pregnant women with intrauterine growth restriction/oligohydramniosCombined insulin‐like growth factor binding protein‐1/interleukin‐6 (Premaquick) versus fetal fibronectin for predicting preterm delivery among women with preterm contractions, Please enable it to take advantage of the complete set of features! An International Journal of Obstetrics & GynaecologyI have read and accept the Wiley Online Library Terms and Conditions of Use These adverse events were also reported at similar rates in the nifedipine‐alone group (23 patients, 19.5%). Nifedipine for preterm labour INFORMAL COPY WHEN PRINTED Page 4 of 9 Public-I 4A Product information1 Nifedipine, a dihydropyridine calcium channel blocker, is an effective smooth muscle relaxant with low toxicity. Our aim was to determine whether this combination has a superior effect to nifedipine alone in terms of inhibiting threatened PTL and improving perinatal outcomes.This randomised study was approved by the ethics committee of Menoufia University Hospitals, Shebin El‐Kom, Egypt (OB/GYN protocols November 2014). Statistical tests: *Mann‐Whitney and you may need to create a new Wiley Online Library account.Enter your email address below and we will send you your usernameIf the address matches an existing account you will receive an email with instructions to retrieve your username was not considered before randomisation; (3) SC was only used in combination with nifedipine, so testing the effect of SC alone on threatened PTL was not done; (4) only one dose regimen was used, although comparing the effect of different regimens may give different results; (5) the trial was not placebo‐controlled; (6) maternal serum SC concentration was not measured; (7) all or some of the patients had progesterone therapy to prevent PTL; (8) we were unable to determine the efficacy of this new combination for twins or preterm premature rupture of membranes due to their exclusion.An ideal tocolytic agent should be easily administered, safe, specific to the myometrium, well tolerated, and rapidly absorbed, with few adverse effects.In the human myometrium, the NO‐cGMP pathway (the target for SC) has an important role in maintaining uterine homeostasis by its relaxing effect. Epub 2015 Mar 19.van Vliet E, Dijkema GH, Schuit E, Heida KY, Roos C, van der Post J, Parry EC, McCowan L, Lyell DJ, El-Sayed YY, Carr DB, Clark AL, Mahdy ZA, Uma M, Sayin NC, Varol GF, Mol BW, Oudijk MA.BJOG. Despite attempts aimed to reduce its incidence, statistics for 2010 showed that 14.9 million neonates were born preterm and of these 1.6 million were born very preterm (<32 weeks’ gestation).A previous preterm birth is the strongest risk factor associated with PTL, with a relative risk (RR) of 6.0 [95% confidence interval (CI) 4.1–8.8] if the preterm birth was at <32 weeks and RR 4.8 (95% CI 3.9–6.0) if birth was between 32 and 36 weeks.Tocolytic therapy is used to postpone delivery for 24–48 hours to allow enough time for administration of corticosteroids to reduce the incidence and severity of respiratory morbidity and to arrange in utero transfer to a centre with proper neonatal intensive care unit (NICU) facilities.Calcium channel blockers such as nifedipine reduce muscle contractility by decreasing calcium influx into cells. Listing a study does not mean it has been evaluated by the U.S. Federal Government. The study was also registered at ClinicalTrials.gov (We would like to acknowledge all the obstetrics staff (nurses, doctors, and study coordinators) and all NICU staff (nurses and doctors) at Menoufia University Hospitals, Shebin El‐Kom, Egypt.Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors.
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