Evaluation of the comparative influence of magnesium sulfate single and combination with ritodrine hydrochloride in the prevention of preterm delivery / Avaliação da influência comparativa de sulfato de magnésio único e combinação com cloridrato de ritodrina na prevenção de parto prematuro

This project was designedto explore the effects of ritodrine hydrochloride combined with magnesium sulfate in the prevention of preterm delivery of patients with threatened premature birth. 128 cases of threatened premature birth were randomly divided into two groups according to the number table method. The control group was treated with magnesium sulfate, while the study group was treated with ritodrine hydrochloride combined with magnesium sulfate. The data (p > 0.05) was analyzed using SPSS 18.0 and was subjected to Chi-square and t-test. The onset time and prolonged gestation time of the study group were shorter than those of the control group (p < 0.05). There was no difference in the incidence of myocardial ischemia between the study group and the control group (p > 0.05). The heart rate per minute of the study group was higher than that of the control group (p < 0.05). There was no difference in blood pressure between the study group and the control group. Nevertheless, the neurological function, pregnancy outcome, and neonatal status of the group were better than those of the control group (p < 0.05).(AU)

Este projeto foi desenvolvido para explorar os efeitos do cloridrato de ritodrina combinado com sulfato de magnésio na prevenção do parto prematuro de pacientes com risco de nascimento prematuro. 128 casos de nascimento prematuro ameaçado foram divididos aleatoriamente em dois grupos, de acordo com o método da tabela numérica. O grupo de controle foi tratado com sulfato de magnésio, enquanto o grupo de estudo foi tratado com cloridrato de ritodrina combinado com sulfato de magnésio. Os dados (p > 0,05) foram analisados pelo SPSS 18.0 e submetidos ao teste do qui-quadrado e ao teste t. O tempo de início e o tempo prolongado de gestação do grupo de estudo foram menores que os do grupo de controle (p < 0,05). Não houve diferença na incidência de isquemia miocárdica entre o grupo de estudo e o grupo de controle (p > 0,05). A frequência cardíaca por minuto do grupo de estudo foi superior à do grupo controle (p < 0,05). Não houve diferença na pressão arterial entre o grupo de estudo e o grupo de controle. No entanto, a função neurológica, o resultado da gravidez e o status neonatal do grupo foram melhores do que os do grupo de controle (p < 0,05).(AU)

Efficacy and side effect of ritodrine and magnesium sulfate in threatened preterm labor

OBJECTIVE: In terms of efficacy, several previous studies have shown that the success rate in inhibiting preterm labor was not different between magnesium sulfate and ritodrine. However, there is a paucity of information regarding the efficacy of both medications after consideration of intra-amniotic infection, which is one of the most important prognostic factors in patients of threatened preterm birth. The objective of this study was to compare the efficacy and safety of magnesium sulfate with that of ritodrine in preterm labor. METHODS: In this retrospective cohort study, we included patients who were admitted and treated with either ritodrine or magnesium sulfate with the diagnosis of preterm labor at 24–33.6 weeks of gestational age between January 2005 to April 2015. Patients were divided into 2 groups according to the first-used tocolytics (ritodrine group and magnesium sulfate group). We compared the efficacy and prevalence of side effect in each group. The efficacy of both tocolytics was evaluated in terms of preterm delivery within 48 hours, 7 days, or 37 weeks of gestation and need for 2nd line therapy. RESULTS: A total number of 201 patients were enrolled including 177 cases in ritodrine group and 24 cases in magnesium sulfate group. The efficacy of both tocolytics (preterm delivery within 48 hours, 7 days, or 37 weeks of gestation and need for 2nd line therapy) was not different between the 2 groups of cases. In multivariate analysis, gestational age at treatment, twin gestation, intra-amniotic infection and maternal C-reactive protein (CRP) was associated with treatment failure (preterm delivery within 48 hours), but the type of tocolytics was not significantly associated with treatment failure. The type of side effect was different in the 2 groups, but the frequency of total adverse effect, need for discontinuation of therapy because of maternal adverse effect, and severe adverse effect were not different between the two groups of cases. CONCLUSION: The efficacy and safety of magnesium sulfate was similar to ritodrine, and can be a substitute tocolytics. Additionally, failure of tocolytic therapy was determined by gestational age at treatment, twin gestation, intra-amniotic infection, and maternal CRP, not by the type of tocolytics.

Effects of Abdominal Breathing on State Anxiety, Stress, and Tocolytic Dosage for Pregnant Women in Preterm Labor

PURPOSE: The purpose of this study was to identify the effects of abdominal breathing on state anxiety, stress and tocolytic dosage for pregnant women in preterm labor. METHODS: The participants were 60 pregnant women in preterm labor who were hospitalized from April to July, 2009. Thirty participants were assigned to the experimental group and 30 to the control group. None of them had any other complications except preterm labor. The modified Mason's breathing technique was used with the experimental group 3 times a day for 3 days. Data were collected using a self-report questionnaire and chart review, and analyzed with the SPSS 13.0 WIN program. RESULTS: "State anxiety of the experimental group will be lower than that of the control group" was supported. "Stress of the experimental group will be lower than that of the control group" was supported. "The Ritodrine dosage for the experimental group will be lower than that of the control group" was supported. "The Atosiban dosage for the experimental group will be lower than that of the control group" was supported. CONCLUSION: These results indicate that abdominal breathing is an effective nursing intervention for pregnant women in preterm labor.

A Case of Acute Generalized Exanthematous Pustulosis Possibly Induced by Ritodrine

Acute generalized exanthematous pustulosis is a skin reaction characterized by an acute onset, fever, and a cutaneous eruption with non-follicular sterile pustules on edematous erythema. It mimics many of the features of pustular psoriasis but is differentiated by its characteristic clinical course and history. The cause is usually ingested drugs. We report a case of acute generalized exanthematous pustulosis possibly induced by ritodrine

Prevention of preterm labor: a prospective comparative study between ritrodine Vs magnesium sulphate

To determine the best method of active management of preterm labour with intact membranes comparing ritodrine vs magnesium sulphate. Prospective clinical trial. Department of Obstetrics and Gynecology. Cairo University, Cairo, Egypt. Sixty women with threatened preterm labore and intact membranes were divided to two group; Group 1: 30 women received ritodrine and Group 2:30 patients received magnesium sulphate. Close monitoring for the mother and fetus during treatment was performed. When successful tocolysis was achieved, patients were transferred from the casuality unit to the antenatal care unit to be put under observation. Ritodrine delayed delivery for 48 hours in 80% of the patients. Several complications were noted with ritodrine. Tachycardia occurred in 18 patients, dyspnea occurred in 4 patients and the drug was discontinued in 2 patients after consultation of the cardiologist to avoid pulmonary oedema.Fetal tachycardia occurred in 4 patients, magnesium sulphate delayed delivery for 48 hours in 73% of the cases. Complications were less frequent with magnesium sulphate, two patients developed tachycardia, 2 patients complained of headache and 3 patients complained of dyspnea. Magnesium sulphate is tolerated better than ritodrine with similar effectiveness

Hyperkalemia after Cessation of Ritodrine in a Parturient during Cesarean Section: A case report / 대한마취과학회지

Ritodrine hydrochloride is widely used for the treatment of premature uterine contraction because the drug has beta2-sympathomimetic effect on the uterus. Hypokalemia is one of the most common side effects of ritodrine. We experienced a case of hyperkalemia without ECG change that occurred during cesarean section in a healthy parturient, associated with low-dose ritodrine pretreatment for six and half hours to stop preterm labor. We treated the patient with potassium-free fluid and calcium chloride. Plasma potassium level returned to normal four hours after the ritodrine had been terminated.

Two Cases of Delayed Interval Delivery of the Second Twin / Journal of Rural Medicine

We report on two cases of diamniotic dichorionic pregnancy with delayed delivery of the second twin. Case 1 was a 29-year-old woman with a twin pregnancy at 19 weeks and 0 day presenting with a preterm rupture of the membranes (PROM) of the first twin. The patient was treated with ritodrine and systemic broad-spectrum antibiotics. Six hours after admission, the first twin was delivered stillborn without complication. At 23 weeks and 5 days, preterm labor resulted in and the second twin being delivered stillborn at a weight of 564 g. The interval between the first and second delivery was 33 days. Case 2 was a 30-year-old woman with a twin pregnancy at 15 weeks and 4 days presenting with amniotic fluid leakage. PROM was found, and she was treated with ritodrine and systemic broad-spectrum antibiotics. The next day, the first twin was delivered stillborn. At 26 weeks, due to adverse effects, ritodrine was changed to isoxsuprine and magnesium sulfate to control uterine contractions. At 33 weeks and 5 days, onset of labor was observed, and 11 hours after the cessation of treatment with isoxsuprine and magnesium sulfate, a viable female fetus was delivered by spontaneous vaginal delivery, weighing 1,806 g. The mother developed atonic bleeding of the uterus immediately after delivery.;The interval between the first and second twin deliveries was 33 days in case 1 and 127 days in case 2. The longer interval resulted in better fetal outcome, but it also may have increased the risk to the mother.

Effects of Abdominal Breathing on Preterm Labor Anxiety / 여성건강간호학회지

PURPOSE: The purpose of this study was to explore the effects of abdominal breathing on relieving anxiety in women diagnosed with preterm labor. METHOD: This was a pilot study, which was based on a repeated pre-post experiment design without a control group. Seven patients with preterm labor who were admitted to Y university medical center, Seoul, Korea, participated in the experiment. They were under receiving ritodrine hydrochloride(Yutopa) as tocolytic therapy and did not have any other complications. The patients were taught abdominal breathing, which is a modified version of Mason's breathing technique. The experimental treatments were done 33 times from February 18 to June 19 in 2005. RESULT: After abdominal breathing, the average psychological anxiety level decreased significantly. The physical anxiety levels of preterm labor patients were measured by blood pressure, pulse, and skin temperature. After abdominal breathing, the average systolic and diastolic blood pressure decreased from 117.3mmHg to 107.6 mmHg (z=-3.85, p<.001) and from 67.3mmHg to 62.7 mmHg (z=-3.14, p<.005), respectively. The average pulse rate also decreased from 97.2/min to 89.8/mim (z=-4.76, p<.001). The average skin temperature increased from 94.0 to 94.9(z=-4.80. p<.001). CONCLUSION: Abdominal breathing is effective for relieving anxiety of women diagnosed with preterm labor. This study, however, has been limited to short-term effects, and therefore further studies are required in order to examine the long-term effects of abdominal breathing.

A case of elevated serum transaminase levels associated with the use of ritodrine during pregnancy / 대한산부인과학회지

Ritodrine hydrochloride (Yutopar) is commonly used for the treatment of preterm labor. Published reports claim that many complications of prematurity have been averted by the administration of this drug. However, ritodrine hydrochloride has many side effects, including cardiovascular problem and metabolic error. Only a few reports have described the transient hepatitis (elevated transaminase) all over the world. The clinical significance and incidence of this side effect are still unclear. In this report, we present a case of elevated serum transaminase levels associated with the use of ritodrine during pregnancy with a brief review of the literatures.

Ritodrine in the treatment of preterm labour: a meta-analysis.

BACKGROUND & OBJECTIVES: Results on the effect of ritodrine in the treatment of preterm labour are different all over the world. Therefore, a concrete conclusion cannot be drawn from a single randomized control trial (RCT). In this study, we selected a large number of RCTs worldwide on the treatment of preterm labour comparing ritodrine and placebo or magnesium sulfate and by applying meta-analysis, evaluated the effect of ritodrine in the treatment of preterm labour. METHODS: We searched and identified 20 RCTs about ritodrine versus placebo, and ritodrine versus magnesium sulphate in the main medical data resources (MEDLINE, PubMed, CBMdisc, Cochrane Library and EMBASE) from January 1970 to December 2001 published in English and Chinese literature. We abstracted data about delay of gestation, gestational age at delivery, birth weight, severe neonatal respiratory system diseases, perinatal deaths, and administration to contraction-ceased interval, etc. RESULTS: The odds ratio (OR) of 1 day (d) delay in 10 RCTs on ritodrine in preterm labour versus placebo was 2.95 (95%CI 2.15, 4.04), and OR of 2d delay was 1.91 (95%CI 1.49, 2.45), both differences were statistically significant. There were no significant difference on the OR of birth > or =37 wk, birth weight > or =2500 g, severe respiratory morbidity and perinatal mortality. The OR of 2d delay of four RCTs from abroad on ritodrine versus magnesium sulphate was 1.56 (95%CI 0.62, 3.94), and OR of 7d delay was 1.45 (95%CI 0.80, 2.62), both without significant difference. But the combined estimated rate difference (CERD) of side effects interruption rate was 12 per cent with significant difference. There were six Chinese RCTs on ritodrine and magnesium sulphate. The OR of 1d delay was 3.95 (95%CI 1.98, 7.88), and OR of neonatal death was 0.45 (95%CI 0.22, 0.93), both with significant difference. The average administration to contractionceased interval were 2.5 and 6.3 h, respectively, with CERD being -4.2 h. INTERPRETATION & CONCLUSION: In treating preterm labour, ritodrine can significantly prolong a short interval more quickly but with relatively more side effects than magnesium sulphate. Stratified RCTs for different gestational ages and different labour stages should be designed for further study.

Perception of Parental Sex Role by University Student / 여성건강간호학회지

PURPOSE: This study was conducted to describe the perception of parental sex role held by university students and to examine differences in perception of parental sex role according to student characteristics. METHOD: The participants were 336 university students in Gangreung city. The instrument of parental sex role was developed by the researcher and consisted of 3 subcategories; general parent role, parental sex role as a father and parental sex role as a mother. RESULTS: The most positive item of parental sex role as a father is 'the Father's role is teaching about the value of society'. The most positive item of parental sex role as a mother is 'the Mother's role is to be a counselor or friend'. There were significant differences in perception of a father's role according to sex, type of college, fathers who lived with student during childhood, the relationship with the parent, the plan of marriage and having a child, responsibility of child-rearing, and the need for education for the parental role. There were significant differences in perception of the mother's role according to sex, grade, type of college, birth order, type of family, persons who lived with student during childhood, the relationship with the parent, plan of marriage and having a child, responsibility of child-rearing, and the need for education for the parental role. CONCLUSION: The parental sex role changes overtime. Thus, it is important to identify university student's perception of parental sex roles as pre-parent preparation for parenting.

Perception of Parental Role by University Students / 아동간호학회지

PURPOSE: This study was conducted to describe the perception of parental role held by university students and to examine difference in perception of parental role according to student characteristics. METHOD: The participant were 338 university student in Gangreung city. The instrument was developed by researcher and consisted of 4 subcategories ; child rearing environment, parental sensitivity, growth and development of infant, and physical care. Data were collected from May 10 to June 1 in 2004 and were analyzed using SPSS Win 10.0 program. RESULT: The university students' perception of total parental role had a mean item score of 4.02, with 4.12 for parental sensitivity, 4.00 for child rearing environment, 4.00 for physical care and 3.95 for growth and development. There were significant differences in perception of parental role according to sex(t=-5.55, p=.00), grade(F=13.12, p=.00), type of college(F=28.34, p=.00), father's age(F=5.01, p=.00), father's education(F=5.01, p=.00), mother's education(F=3.33, p=.03) student's marriage plan(t=2.37, p=.01) main caretaker(F=9.53, p=.00) person who lived with student in childhood(F=3.62, p=.01) and student's perception of the need for education for parental role(t=3.74, p=.00). CONCLUSION: The impact of childhood experience has lifelong significance on subsequent health and development. Especially, the experience of childhood is highly affected by the quality of parental role. It is important to identify university student's perception of parental role as pre-parent preparation for parenting. Therefore, pre-parent education program are necessary.

Doppler findings and tocolytic effect of transdermal glyceryl trinitrate and intravenous ritodrine as tocolysis of preterm labor / 대한산부인과학회잡지

OBJECTIVE: This study was conducted to compare the safety and efficacy of transdermal glyceryl trinitrate (GTN) in initial therapy for preterm labor with those of intravenous ritodrine hydrochloride and the effects of tocolytics in uteroplacental circulation, as assessed by uterine artery doppler velocimetry. METHODS: Patients between 24 and 34 weeks gestation with documented preterm labor were randomly assigned to receive transdermal GTN (n=24) or intravenous ritodrine (n=35) as initial tocolytic therapy. Patients in the GTN group were administered 0.2 mg/h released transdermal patch on the pregnant women's abdomen directly. Patient in the ritodrine group were treated 0.025 mg/min as initial dose. The dose increased at 15 minute intervals until uterine contractions were inhibited or side effects become intolerable. The maximum recommended dose was 0.20 mg/min. The main outcome examined were failure of tocolysis, time to uterine quiescence, time gained in utero, and frequency of adverse effects. We obtained both right and left uterine artery doppler velocity waveform before and after tocolytics therapy. The mean values of the right and left uterine artery systolic and diastolic ratio were calculated and used for analysis. RESULTS: There were no significant difference in maternal demographic between the groups. Successful tocolysis was observed in 79.2% in the GTN group, and 85.7% in the ritodrine group (p=0.726). Time to uterine stop contraction was 5.5 +/- 5.3 hr in ritodrine group and 1.1 +/- 0.3 hr in GTN group. There were no different in time to gain in uterus between the two groups. The patient in the ritodrine group had more adverse side effects, mainly maternal tachycardia (p=0.002), chest pain and tremor (p=0.035). There was no significant difference in uterine S/D ratios between the pretherapy and posttherapy GTN group. However, we found statistically significant difference between the pretherapy and 24 hr-posttherapy in ritodrine group. CONCLUSION: Transdermal GTN was effective, safe, and well tolerable tocolytic agent. Patients who received ritodrine hydrochloride were more likely to have adverse effects. We also conclude that GTN do not affect uteroplacental circulations as measured by S/D ratios but ritodrine does. This results suggest that progressively increasing dose of ritodrin and GTN maybe associated with a statistically significant decrease S/D ratios. However, further investigations needs to be performed.

A Comparison of Efficacy and Safety of Ritodrine hydrochloride alone and Combined Treatment with Magnesium sulfate in the Management of Preterm Labor / 대한산부인과학회잡지

OBJECTIVE: This study was designed to compare the efficacy and safety of the ritodrine hydrochloride alone with combined treatment with magnesium sulfate in the management of preterm labor. METHODS: One hundred thirty three singleton pregnancies with preterm labor were treated with either ritodrine hydrochloride (n=97) or ritodrine hydrochloride and magnesium sulfate (n=36). The principal outcomes assessed were delay of duration, maternal-fetal side effects, and fetal outcome. RESULTS: The treatment to delivery time was not statistically different between the ritodrine group and the combined magnesium sulfate group (mean+/-SD 10.7+/-13.0 days, 8.6+/-9.1 days, respectively). The proportion delivered after 48 hours, 72 hours, or 7 days was also not statistically different between two groups (29% vs. 22%, 40% vs. 39%, 60% vs. 64%, respectively). No statistical difference was found in the side effects of treatment or fetal outcomes. CONCLUSION: There was no significant difference in efficacy and safety between ritodrine hydrochloride and combined treatment with magnesium sulfate in the management of preterm labor.

Oral Nicardipine Versus Intravenous Ritodrine for the Treatment of Preterm Labor / 대한산부인과학회잡지

OBJECTIVE: This study was conducted to compare the efficacy and safety of oral nicardipine in acute therapy for preterm labor with those of parenteral ritodrine hydrochloride. METHODS: Patients between 24 and 34 weeks' gestation with documented preterm labor were randomly assigned to receive oral nicardipine (n=31) or intravenous ritodrine (n=32) as initial tocolytic therapy. Patients in the nicardipine group received a 40-mg loading dose and then 20 mg every 2 hours as needed to stop contractions (total 80 mg). Patients in the ritodrine group received a 0.05 mg/min as initial dose. The dose was increased at 15-minute intervals until uterine contractions were inhibited or side effects became intolerable. The maximum recommended dose was 0.35 mg/min. Patients could be switched to another tocolytic regimen if they continued to have contractions after 6 hours of therapy. The main outcome variables examined were failure of tocolysis, time to uterine contractions equal or less than 5 times per hour, time to uterine quiescence, time gained in utero, and frequency of adverse medication effects. RESULTS: There were no significant differences in maternal demographic characteristics between the groups. Successful tocolysis, defined as cessation of uterine contractons less than 6 hours from initial dose, was observed in 58.1% in the nicardipine group and 65.6% in the ritodrine group (P=.544). Among patients with successful tocolysis who responded with uterine quiescence within 6 hours, there was no significant difference in the time to uterine quiescence in the ritodrine group (P=.087). Time to uterine contractions equal or less than 5 times per hour from initial treatment showed no significant difference between the two groups with successful tocolysis (P=.097). The patients in the ritodrine hydrochloride group had more adverse side effects, mainly maternal tachycardia (P=.013) and nausea and/or vomiting (P=.006). CONCLUSION: Oral nicardipine was effective, safe, and well-tolerated tocolytic agent. Patients who received ritodrine hydrochloride were more likely to have adverse medication effects.

Effect of Neurotrophins and Depolarization on Survival of Spiral Ganglion Neurons in Dissociation Cell Culture / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Several neurotrophic factors have been shown to play an essential trophic role in the development, maintenance and regulation of neuronal function. Specific neurotrophins are currently used in clinical trials for the treatment of some neurodegenerative diseases. The purposes of this experiment were twofold. Firstly, we aimed to determine the trophic effects of BDNF, NT-3, and 25 mM K+ on auditory neurons in dissociated cultures of early postnatal spiral ganglia. Secondly, we tried to collect pure neural cells after dissociating the spiral ganglions using the immunomagnetic sorting method with one of neuronal surface antigens. MATERIALS AND METHODS: Dissociated spiral ganglion cell cultures were pre-pared from cochleae of Sprague Dawley rats of 5-6 days old, and maintained in a neurobasal medium with modified N2 supplements. BDNF (50 ng/ml), NT-3 (50 ng/ml), and 25 mM K+ were added to the cultures, respectively. These cells were grown during the time course (24hr, 48hr, 72hr, 98hr) and stained with NF-200 to identify survival of spiral ganglion neurons. Immunomagnetic cell sorting for separation of spiral ganglion neurons in dissociated cells was carried out using the MiniMACS Separating System. Magnetically separated cells were analysed by flow cytometry. RESULTS: Survival of the auditory neurons in the dissociated cells was significantly increased by addition of BDNF, NT-3, and 25K. The effect of 25 mM K+ on neuronal survival showed the highest in the experimental conditions. BDNF dramatically increased the neurite length compared with those under other conditions. After immunomagnetic sorting in dissociated cultures, spiral ganglion neurons were shown to contain 50% of the fluorescently labeled positive cells. CONCLUSIONS: Neurotrophins (BDNF, NT-3) and depolarization by 25 mM K+ were essential trophic factors for postnatal auditory neurons and BDNF stimulated neuritogenesis in cultured spiral ganglion neurons. The immunomagnetic cell sorting method is not appropriate for collecting pure neural cells from the dissociated cells of spiral ganglia (50% purity).

Placenta previa and the role of tocolytic therapy study at Jordan University Hospital

to study the incidence of placenta previa and aspects of its management [tocolytic treatment] at Jordan University Hospital. prospective and retrospective analysis of 115 women with placenta previa who were admitted over a 6-year period. Fifty-six cases of preterm placenta previa with initial episode of vaginal bleeding were selected. Thirty-three cases were treated with Ritodrine after documentation of uterine contractions and 23 [control group] were not treated. Outcome variables were birth weight, interval from admission until delivery, incidence of recurrent bleeding, and need for blood transfusion. the use of Ritodrine was associated with significant improvement in birth weight [2510 gm vs. 2210 gm, p<0.04 and interval from bleeding until delivery [39.6 vs. 27.4 days, p<0.02]. There was no statistical difference with regard to the incidence of recurrent bleeding, but there was a trend to postpartum blood transfusion in the treated group. Conclusions: use of tocolytic therapy may prolong pregnancy; however, its role in preventing vaginal bleeding needs further exploration

A Comparison for Efficacy and Safety of Magnesium Sulfate(Magrose), Ritodrine Hydrochloride(Yutopar) and Nifedipine(Adalat) in the Management of Preterm Labor / 대한산부인과학회잡지

OBJECTIVES: The aim of this study was to compare the efficacy and safety of magnesium sulfate, ritodrine hydrochloride and nifedipine in the management of preterm labor. MATERIALS AND METHODS: 180 women with documented preterm labor were randomly assigned to receive magnesium sulfate (n=60), ritodrine hydrochloride (n=60) and nifedipine (n=60) as initial tocolytic therapy. 30 women with documented preterm labor were allocated to administer fluid only and bed rest as control group. Patient could be switched to another tocolytic regimen if they continued to have contractions or side effects. The main outcome variables examined were days gain in utero, success rate, side effects and neonatal outcome. RESULTS: There were no significant differences in maternal characteristics between the groups. The days gain in utero was no statistically different in the three groups(magnesium sulfate, ritodrine hydrochloride and nifedipine) but markedly longer in the three groups than the control group (p<.01). The total success rate was similar in the three groups, but side effects were much more in the magnesium sulfate and ritodrine group than the nifedipine group (p<.05). The respiratory distress syndrome in neonate was decreased in the three groups than the control group without statistical significance. CONCLUSION: Nifedipine is an effective, safe, and well-tolerated tocolytic agent. In this retrospective study, total success rate of controlling preterm labor was similar in the three groups, but patients who received nifedipine were less side effects than magnesium sulfate or ritodrine group.

Prospective randomized study comparing nifedipine versus ritodrine for the suppression of preterm labour

Nifedipine is a dihydropyridine and a calcium channel blocker during the second phase of the action potential of uterine smooth muscle cells, and ritodrine is a beta-sympathomimetic. Objective of Study: To compare the efficacy and side-effects of oral nifedipine to ritodrine in the inhibition of preterm labour. Methodology: Sixty parturients admitted to the Maternity Hospital with preterm labour who fulfilled the inclusion criteria were randomized into two equal therapy groups: [a] oral nifedipine [n = 30] and [b] intravenous ritodrine [n = 30]. During the period, the parturients were under continuous monitoring of fetal well-being, maternal uterine contractions, blood pressure, and pulse and respiratory rates. Both groups were given dexamethasone and followed up through delivery and the early neonatal period. The incidence of preterm deliveries during the study period was 6.5%. Ritodrine had a quicker onset of inhibition of uterine contractions, especially between 20 and 40 min after initiation of tocolytic therapy [p < 0.04]. Labour was delayed on the average for 40 h in the nifedipine group compared to 24 h in the ritodrine group [p < 0.05]. Eighteen patients [60%] in the nifedipine group had cessation for more than 48 h compared to 7 [30.4%] in the ritodrine group [p < 0.05]. Nifedipine inhibited uterine contractions for more than 7 days in more patients than ritodrine [13 versus 5, p < 0.05]. Ten patients in the nifedipine group went beyond 36 weeks of gestation compared to 4 in the ritodrine group [p < 0.03]. In 5 [17.9%] of the ritodrine group compared to none in the nifedipine group, treatment was abandoned because of severe side-effects of nausea [11 versus 2, p < 0.01] and palpitations [16 versus 3, p < 0.004]. There were no significant differences in the Apgar scores and neonatal morbidity. More infants in the ritodrine group [17, 73.9%] than in the nifedipine group [14, 46.1%, p < 0.05] were admitted to the neonatal unit. Nifedipine is recommended for aborting preterm contractions because it has fewer side-effects, superior efficacy and greater ease of administration than intravenous ritodrine