Related Experiment Videos
[Nitroglycerin patch for tocolysis--a prospective randomized comparison with fenoterol by infusion].
E Schleussner1, S Richter, W Gross
1Klinik für Frauenheilkunde und Geburtshilfe, Abteilung Geburtshilfe, Klinikum der Friedrich-Schiller-Universität Jena. ekkehard.schleussner@med.uni-jena.de
Zeitschrift Fur Geburtshilfe Und Neonatologie
|December 1, 2001
Summary
Transdermal glyceryl trinitrate (GTN) demonstrated equivalent tocolytic efficacy to fenoterol, leading to longer gestations and fewer neonatal care transfers. GTN also presented with fewer maternal side effects, making it a favorable option for preterm labor management.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
- Neonatal Medicine
Background:
- Preterm labor is a significant concern in obstetrics, necessitating effective tocolytic agents.
- Fenoterol, a beta-mimetic, is an established treatment for preterm labor but is associated with maternal side effects.
- Transdermal glyceryl trinitrate (GTN) offers a potential alternative for tocolysis.
Purpose of the Study:
- To compare the tocolytic efficacy of transdermal glyceryl trinitrate (GTN) against intravenous fenoterol.
- To evaluate the impact of both treatments on gestational prolongation and neonatal outcomes.
- To assess maternal side effects associated with each tocolytic agent.
Main Methods:
- A prospective, randomized, multicenter study involving 50 pregnant women (27-35 weeks gestation) with preterm labor.
- Participants received either GTN patches (0.4-0.8 mg/h) or intravenous fenoterol (60-120 micrograms/h).
- Primary outcomes included prolongation of gestation (48h, 7 days, up to 37 weeks) and neonatal outcome; secondary outcomes were cervical ripening and maternal side effects.
Main Results:
- No significant difference in tocolysis success at 48 hours or 7 days between GTN and fenoterol groups.
- Significantly more women in the GTN group reached 37 weeks gestation.
- GTN therapy resulted in longer mean gestation, greater birth weight, and reduced transfers to neonatal care, with fewer and milder maternal side effects (headache) compared to fenoterol (tachycardia, tremor).
Conclusions:
- Transdermal GTN is at least as effective as fenoterol for tocolysis in preterm labor.
- GTN therapy leads to a lower preterm delivery rate and reduced neonatal care admissions with comparable neonatal outcomes.
- Transdermal GTN offers a favorable safety profile with fewer maternal side effects than fenoterol, apart from transient headaches.