Introduction
Preterm labor is one of the most important problems in pregnancies, and
it can have serious consequences, such as premature birth and its
complications (1, 2). In the past, fetal mortality was high in preterm
labor. However, these days, with the identification of these pregnancies
and proper care of the mother and fetus, the fetal mortality rate in
these pregnancies has been reduced; but even so, further research is
needed (3, 4). Premature birth, in addition to causing economic,
psychological, and psychological problems in the family, also results in
the loss of financial and human resources (5). It has received special
attention in recent years because it is a painful and stressful
experience for both infants and parents(6). Premature infants are
readmitted at a rate of 11 per 1000 live births that were alive three
months after discharge, which is significantly higher than the rate for
term babies (7). Given that a decrease in infant mortality rates
indicates an improvement in public health (8), measures to reduce the
number of preterm births are especial important factors (9). Nowadays,
treatment methods such as taking progesterone orally or injecting it, or
taking drugs with vasodilating properties such as Nifedipine, are common
(10, 11), but determining the most effective treatment in this field
necessitates research. It is a clinical trial with a comparative
intervention. For many years, magnesium sulfate has been known to be
effective in this field(12); Magnesium sulfate, chemically known as
MgSO4, is an injectable drug with clinical applications that include
seizure prevention in preeclampsia, preterm labor, and, on rare
occasions, the treatment of cardiac arrhythmias. Both the injectable and
oral forms are used to treat hypomagnesemia, as well as bronchodilators
and osmotic laxatives. Its cellular effect was mediated by inhibiting
the release of acetylcholine at the nerve-muscle junction, thereby
inhibiting calcium entry into cells due to increased intracellular
magnesium. Its anticonvulsant effect is due to the blocking of calcium
neurons via the glutamate duct (which is only found in the CNS) and its
anticonvulsant effect on the cerebral cortex without causing CNS
depression in the mother and fetus. Indomethacin is also available in
pill, capsule, and suppository form as a nonsteroidal anti-inflammatory
drug (NSAID). Indomethacin is a powerful analgesic and anti-inflammatory
drug that is also used to prevent uterine contractions. Indomethacin
works by inhibiting the enzyme cyclooxygenase to convert arachidonic
acid to prostaglandin. Prostaglandins play a significant role in both
term and preterm labor. Despite extensive researchs, no single drug has
been introduced as the first line of treatment, and the choice of drug
is based on drug availability, effectiveness, maternal and neonatal
complications, and drug price. Due to the huge importance of the subject
in this study, the effect of Magnesium Sulfate and Indomethacin
suppository with the administration of Magnesium Sulfate alone in
inhibiting preterm delivery in women aged 24 to 32 weeks at Kosar
Hospital in Qazvin in 2019 and 2021 years was compared.