Prospective controlled study of intravenous ritodrine terbutaline and magnesium sulfate bolus for treatment of acute intrapartum fetal, distress

ABSTRACT

Tocolytic agents had been used with variable results in the treatment of acute intrapartum fetal distress. We studied 121 cases in this prospective, randomized trial to evaulate the efficacy and mate-nial, fetal and neonatal outcome associated with tocolysis with intravenous bolus of either ritodrine [group A of 32 cases], terbutaline [group B of 30 cases] or magnesium sulfate [Group C of 31 cases]. Group D consited of 29 cases as a control and received no tocolytic therapy. Fetal distress was diagnosed according to abnormal external and internal cardiotocographic [CTG] results during intrapartum fetal monitoring. Recovery of the abnormal fetal heart rate was reported in 81.3%, 76.7% and 54.8% in groups A, B, and C respectively. Fetal and neonatal outcome were favorable with ritodrine and terbutaline use compared to magnesium sulfate and control groups difference was significant depending on neonatal umbilical vein pH and Apgar score. A lower incidence of cesarean section was noticed among women received tocolytic therapy compared to control [P<0.05]. Minor side-effects were reported. Beta-adrenergic agonists are recommended as effective, safe therapy, compared to magnesium sulfate which is less effective with higher fetal and neonatal acidosis and distress