The effect of Nifedipine on embryo transfer outcomes: A randomized clinical trial

Background: Endometrial receptivity is crucial for embryo implantation, and excessive uterine contraction reduces success. Nifedipine which is a calcium channel blocker, could decrease uterine contraction and improve pregnancy outcomes. Objective: This study aimed to assess the effect of Nifedipine before embryo transfer on the pregnancy outcome in women undergoing in vitro fertilization (IVF) in a tertiary center in Iran. Materials and Methods: 150 women who were candidates for IVF were randomly assigned into 2 groups: group 1 received 20 mg Nifedipine 30 min before embryo transfer, and group 2 received no intervention. Blood pressure of the participants was monitored every 10 min for 1 hr under the supervision of an anesthesiologist. Finally, implantation rate and chemical and clinical pregnancy rates were compared between groups. Results: At the end of the study, 140 participants were included in the final analyses. No significant difference was observed in clinical pregnancy rates between groups (20% vs. 22%, p = 0.51) Conclusion: Nifedipine administration before embryo transfer does not improve the implantation and clinical pregnancy rates in women undergoing IVF. Key words: Nifedipine, In vitro fertilization, Uterus, Contraction

Comparison of Preventive Acetaminophen and Placebo in Pain Reduction After Cesarean Section; A Randomized Clinical Trial

Background: In subjects having a cesarean section, pain can increase hospital length of stay and postoperative complications. The preventive analgesia in the postoperative phase is known to be more effective than analgesic treatment in response to pain. Objectives: In this study, the analgesic efficacy of preventive intravenous acetaminophen was compared with placebo in relieving postoperative pain after cesarean sections under spinal anesthesia. Methods: In this double-blind randomized controlled study, 49 women undergoing elective cesarean section under spinal anesthesia were randomly allocated into two groups by block randomization in a referral hospital in Tehran in 2016. The intervention group received intravenous acetaminophen (Apotel®) (1 gram) and the placebo group received normal saline on arrival to the recovery room within 20 minutes. Then the total consumed doses of meperidine, visual analogue scale (VAS) score of pain, and the incidence of vomiting were determined and recorded for 24 hours postoperatively. Results: Pain scores (VAS) were lower in the acetaminophen group throughout the study, but the difference was only significant at forth to eighth hours after the surgery (P = 0.0001). The total consumed doses of meperidine to treat the pain was significantly lower in the acetaminophen group at the fourth to the eighth hours after the surgery (P = 0.0001). The incidence of vomiting was the same between the groups (P > 0.05). Conclusions: A single dose preventive intravenous acetaminophen has good efficacy in reduction of postoperative pain and reduces opioid use after cesarean sections under spinal anesthesia up to 8 hours after the administration