الفهرس 
Acknowledgements
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Abstract
Antepartum hemorrhage (APH) is defined as bleeding from or within the female genital tract, occurring from 28+0 weeks of pregnancy and till delivery of the fetus. APH occurs in 3–5% of pregnancies and is an important cause of perinatal and maternal morbidity and mortality worldwide (Ghi et al., 2009). Many studies in literature proved the positive correlation between the PP and preterm uterine contractility and also reported that large proportion of women who have PP associated with vaginal bleeding will have subclinical uterine contractions before the onset of evident vaginal bleeding. There are many tocolytic drugs may have a role in conservative management of PP; these drugs can prolong the pregnancy and result in an increase in birth weight of the babies without causing any adverse effect on the mother and fetus. The objective of our study is to compare the effectiveness of magnesium sulfate and nifedipine in the management of patients admitted with the diagnosis of placenta previa with preterm uterine contractions. In addition, our study will try to assess the safety of these tocolytics on the mother by assessing a selected number of outcome variables. Our aim was to compare the efficacy and safety of magnesium sulfate and nifedipine in the management of preterm labor cases of placenta previa and to compare neonatal outcome in both groups. The present study is a randomized clinical trial study compassing from 2017 to 2019. that was carried out at the Obstetrics and Gynecology department, Woman Health Hospital, Assiut University, Assiut, Egypt. Women who met the selection criteria of the study were invited to participate and only those who signed the informed consent were recruited. All patients with diagnosed PP at admission (between 28- and 37-weeks’ gestation) will be counseled for inclusion in the study Confirmed Placenta previa, either major or minor degrees with preterm uterine contractions. All symptomatic patients (bleeders) will receive corticosteroids with the first attack of bleeding. This open label randomized-control trial will be performed on pregnant women admitted to Women Health Hospital, Assiut, Egypt. All patients were randomly assigned equally to either nifedipine or MgSO4 groups. 88 patients in each group. Our Primary Outcome was prevention of delivery for 48 hours with attainment of uterine quiescence. Failure of the primary outcome occurred if, in the first 48 hours, patients delivered, ruptured previously intact membranes, experienced recurrent preterm labor, continued to contract or change their cervix throughout Our Secondary Outcomes were Gestational age at delivery, birth weight, APGAR score, and need for resuscitation, NICU admission. 176 patients met the inclusion criteria in our study .88 patients in each group with successful prolongation duration of pregnancy (71.6% in MGSO4 and 78.4% in Nifedipine, ±6 days and ±8 days prolongation of pregnancy duration respectively). Both groups had insignificant differences as regard Apgar score. Admission to neonatal intensive care unit was required in 25 (28.4%) and 16 (18.2%) of magnesium sulfate group and nifedipine group, respectively with insignificant differences between both groups. 3 patients in each group were excluded due to stoppage of drug due to side effects where recurrent uterine contractions occurred after it had been inhibited. Patients receive supportive measures and no serious adverse effects happened.