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Hemodynamic and metabolic effects after nifedipine and ritodrine tocolysis
Author(s) -
Papatsonis D.N.M.,
van Geijn H.P.,
Bleker O.P.,
Adèr H.J.,
Dekker G.A.
Publication year - 2003
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/s0020-7292(03)00145-0
Subject(s) - nifedipine , ritodrine , medicine , hemodynamics , anesthesia , tocolytic agent , blood pressure , heart rate , diastole , preterm labor , fetus , pregnancy , gestation , calcium , biology , genetics
Objectives: The purpose of this study is to compare the hemodynamic and metabolic changes after ritodrine and nifedipine tocolysis. Methods: For an open randomized study, patients with preterm labor ( N =185) were allocated to groups to receive ritodrine intravenously ( N =90) or nifedipine orally ( N =95). Results: The mean diastolic blood pressure was significantly lower in the ritodrine group 24 h (65±12 vs. 70±8, P =0.001) and 48 h (65±12 vs. 71±8, P =0.004) after starting tocolysis compared with the nifedipine group. Mean maternal heart rate was significantly higher in the ritodrine group 24 h (105±17 vs. 86±13, P <0.0001) and 48 h (100±21 vs. 85±12, P <0.0001) after starting tocolysis compared with the nifedipine group. Mean fasting glucose levels were higher (6.68±2.53 vs. 4.93±1.23, P =0.0016), while mean potassium levels were lower (3.52±0.84 vs. 3.81±0.45, P =0.04) in the ritodrine group 48 h after starting tocolysis compared with the nifedipine group. Conclusions: Use of nifedipine for preterm labor is associated with a lower incidence of adverse hemodynamic and metabolic changes compared with ritodrine after 24 and 48 h of tocolysis. In our opinion nifedipine is the preferred drug of choice for the treatment of preterm labor.