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Tocolytic effects of intravenous nitroglycerin
Marina de Spirlet1, Jean-Marc Treluyer, Sylvie Chevret
1Pharmacologie Clinique, Groupe hospitalier Cochin Saint-Vincent-de-Paul (AP-HP), Université Paris V, Paris, France.
Fundamental & Clinical Pharmacology
|April 7, 2004
Summary
Nitroglycerin showed limited success in stopping preterm labor contractions, with a 54% success rate at the highest dose. Side effects like headaches and decreased blood pressure suggest it
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
Background:
- Current tocolytic agents offer limited efficacy in delaying preterm birth.
- Existing treatments do not significantly reduce perinatal morbidity or mortality.
Purpose of the Study:
- To evaluate the efficacy and safety of nitroglycerin as a novel tocolytic agent.
- To determine the optimal dose of nitroglycerin for managing preterm labor.
Main Methods:
- A double-blind, dose-finding study using a continual reassessment method.
- Investigated six different doses of nitroglycerin (0.2-1.2 mg/h for 2 h).
- Included pregnant women unresponsive, intolerant, or contraindicated to salbutamol.
Main Results:
- The maximal dose (1.2 mg/h) achieved only a 54% success rate in stopping uterine contractions.
- Significant side effects included headaches (12 patients) and decreased arterial blood pressure (16 patients).
Conclusions:
- Nitroglycerin demonstrated insufficient efficacy for controlling preterm labor contractions in this patient group.
- Adverse effects limit the potential for dose escalation to improve success rates.