الفهرس 
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Abstract
Sixty patients attending the emergency unit of obstetrics and gynecology department of Suzan Mubarak University hospital from July 2005 to December 2006 complaining of PTL with intact membrane were considered candidates for this study. Preterm labor was diagnosed as regular uterine contractions less than 10 minutes apart resulting III a documented cervical changes or cervical dilatation less than 2cm.
Singleton pregnancy with a gestational age between 20 and 34 weeks determined by reliable last menstrual period, or ultrasound was included.
Cases with obstetric and medical indications for termination of pregnancy e.g. uncontrolled diabetes, severe pre-eclampsia, hypertension, ante partum hemorrhage, chorioamnionitis, oligo-or polyhydramnios, Severe anemia, Cardiac disease, Renal failure, allergy to specific tocolytic therapy as well as progressive cervical dilatation and effacement more than 4 cm were excluded from the study. TIJFD, IUGR, fetal distress, fetal congenital anomalies incompatible with life, multiple pregnancIes or premature rupture of membrane were also excluded.
Selected patients were subjected to counseling, history taking, detailed obstetrics, general, abdominal and local examination. Routine maternal investigations were done. Ultrasound examination was preformed routinely to determine the gestational age, presentation, placental location and the presence of fetal anomalies as well as the amniotic fluid index.
Patients were randomly allocated as: group (I): received nifedipine and group (II): received ritodrine HCL according to the specific protocol of each drug.
Each patient received the following initial treatment: 500 ml fluid of isotonic saline, followed by a maintenance rate of 100 ml / h, with total fluid volume of 2500 ml / 24 hrs, monitored by fluid chart, 2 gm of Ampicillin before the results of the culture sensitivity and dexamethazone i.m 6-8 mg in a single dose.
All patients were followed up clinically and the success rate was defined by the number of patients who responded to the tocolytic therapy with decrease in the uterine contractions less than 4 contractions / h with no cervical changes. Tocolytic failure was defined by the number of patients delivered in less than 48 hrs after the start of the specific therapy. Patients who were stable on the tocolytic were kept hospitalized for another 24 to 48 hrs then discharged for follow up.
Perinatal outcomes were recorded including gestational age at delivery, birth weight at delivery, Apgar scores < 7 (I & 5 minutes), NIeU admission, RDS, and NND.
There were no statistically significant ’difference between the two groups as regard age distribution, parity distribution, occurrence of PTL or abortion in previous pregnancies, the different gestational age parameters at time of admission and cervical dilatation and effacement.
It was noted that there was more prolongation of pregnancy in nifedipine group than ritodrine but the difference was not significant. It was shown that the cervical status is the most important factor in determining success of tocolysis. However the difference between the two groups was statisticall~ not significant. The admission-suppression interval was slightly shorter in nifedipine group but the difference was statistically not significant. The success rate was higher and the failure