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Tocolysis

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https://www.readbyqxmd.com/read/29297950/effects-of-vaginal-progesterone-for-maintenance-tocolysis-on-uterine-electrical-activity
#1
Miha Lucovnik, Andreja Trojner Bregar, Lea Bombac, Ksenija Gersak, Robert E Garfield
AIM: The effectiveness of vaginal progesterone for maintenance tocolysis after arrested preterm labor remains controversial. Myometrial contractility can be assessed objectively and non-invasively after progesterone treatment by monitoring uterine electromyography (EMG). We examined the effects of vaginal progesterone on uterine EMG after successful acute tocolysis. METHODS: This was a randomized, double-blind, single-center study performed between 2012 and 2015...
January 3, 2018: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29289935/association-between-total-dose-of-ritodrine-hydrochloride-and-pulmonary-oedema-in-twin-pregnancy-a-retrospective-cohort-study-in-japan
#2
Satoshi Shinohara, Rei Sunami, Yuzo Uchida, Shuji Hirata, Kohta Suzuki
OBJECTIVE: Pulmonary oedema is recognised as a severe side effect of ritodrine hydrochloride. Recently, the number of twin pregnancies has been increasing. Few studies have reported the association between total dose of ritodrine hydrochloride prior to delivery and pulmonary oedema in twin pregnancy. We aimed to examine this association and determine the optimal cut-off threshold of total ritodrine hydrochloride dose to predict the incidence of pulmonary oedema in twin pregnancy based on obstetric records...
December 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/29239057/in-which-preterm-labor-patients-is-intravenous-maintenance-tocolysis-effective
#3
Satoshi Yoneda, Noriko Yoneda, Kaori Fukuta, Tomoko Shima, Akitoshi Nakashima, Arihiro Shiozaki, Osamu Yoshino, Mika Kigawa, Taketoshi Yoshida, Shigeru Saito
AIM: We evaluated whether maintenance tocolysis (intravenous ritodrine hydrochloride and/or magnesium sulfate) was effective in cases of spontaneous preterm labor with intact membranes. METHODS: One hundred and thirty preterm labor patients who reached 36 weeks of gestation by maintenance tocolysis were selected. Immediate delivery (ID) after ceasing maintenance tocolysis was defined as an 'effective case'. The correlated factors between ID and no immediate delivery (NID) were statistically analyzed...
December 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29191291/tocolysis-present-and-future-treatment-options
#4
REVIEW
Joshua D Younger, Elena Reitman, George Gallos
In the United States, the generally accepted indication for tocolytic therapy centers on suppression of preterm labor. This may be in the form of preventative therapy with progesterone in women with prior spontaneous preterm birth or as an acute intervention to suppress established uterine contractions associated with cervical change occurring at less than 37 weeks gestation. This article seeks to apply this perspective to tocolytic therapy. Here, we provide a review of current tocolytic options and what the last decade of discovery has revealed about the regulation of myometrial excitability and quiescence...
December 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/29172176/atp-sensitive-and-maxi-potassium-channels-regulate-brl-37344-induced-tocolysis-in-buffaloes-an-in%C3%A2-vitro-study
#5
Vipin Sharma, Sooraj V Nair, Pooja Jaitley, Udayraj P Nakade, Abhishek Sharma, Soumen Choudhury, Satish Kumar Garg
Cellular coupling of beta3-adrenoceptors (β3-ADR) to potassium channels in myometrium is largely unknown. In vitro study was undertaken to unravel the presence of β3-adrenergic receptors (ADR) and the role of K(+)-channels in mediating β3-ADR-induced relaxation in isolated myometrial strips from cyclic non-pregnant water buffaloes. Isometric tension was recorded in isolated myometrial strips using data acquisition system based physiograph. Compared to SR 59230A, BRL 37344 was found to be more potent in inducing β3-dependent myometrial relaxation which was significantly (p < 0...
November 13, 2017: Theriogenology
https://www.readbyqxmd.com/read/29104681/association-between-beta-sympathomimetic-tocolysis-and-risk-of-autistic-spectrum-disorders-behavioural-and-developmental-outcome-in-toddlers
#6
Mengühan Araz Altay, Işık Görker, Rakhshanda Aslanova, Leyla Bozatlı, Nesrin Turan, Petek Balkanlı Kaplan
AIM: To investigate whether maternal intravenous beta-mimetic tocolytic therapy increases the risk of autistic spectrum disorders (ASD) and poorer behavioural and developmental outcomes. METHOD: Our study is a prospective case-control study among 90 children between 1.5 and three years old. Cases (n = 46) were toddlers with betamimetic tocolytic exposure; control group toddlers (n = 44) were tocolytic untreated. Treated and untreated groups were also divided into subgroups: term and preterm delivered...
October 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28949010/the-value-of-oral-micronized-progesterone-in-the-prevention-of-recurrent-spontaneous-preterm-birth-a-randomized-controlled-trial
#7
RANDOMIZED CONTROLLED TRIAL
Sherif Ashoush, Osama El-Kady, Gehan Al-Hawwary, Ahmed Othman
INTRODUCTION: Progesterone is becoming universally accepted for preventing recurrent spontaneous preterm delivery. There is, however, poor consensus on the effective types and doses of progesterone to be used. Despite the encouraging available research, the role of oral micronized progesterone has not yet been thoroughly investigated. MATERIAL AND METHODS: We randomized 212 singleton pregnancies with past history of spontaneous preterm delivery at <37 weeks, into a progesterone group (receiving 100 mg oral micronized progesterone, six-hourly, starting at 14-18 weeks until 37 weeks or delivery) and an identical placebo group...
December 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28943054/maintaining-and-repeating-tocolysis-a-reflection-on-evidence
#8
REVIEW
Isabelle Dehaene, Lina Bergman, Paula Turtiainen, Alexandra Ridout, Ben Willem Mol, Elsa Lorthe
It is inherent to human logic that both doctors and patients want to suppress uterine contractions when a woman presents in threatened preterm labor. Tocolysis is widely applied in women with threatened preterm labor with a variety of drugs. According to literature, tocolysis is indicated to enable transfer to a tertiary center as well as to ensure the administration of corticosteroids for fetal maturation. There is international discrepancy in the content and the implementation of guidelines on preterm labor...
September 21, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28813702/tocolysis-for-in-utero-surgery-atosiban-performs-distinctly-better-than-magnesium-sulfate
#9
Nicole Ochsenbein-Kölble, Franziska Krähenmann, Margret Hüsler, Martin Meuli, Ueli Moehrlen, Lucca Mazzone, Peter Biro, Roland Zimmermann
INTRODUCTION: To compare tocolysis with magnesium sulfate versus atosiban regarding the occurrence of short-term preterm labor and maternal side effects during and after open fetal myelomeningocele (MMC) repair. MATERIAL AND METHODS: A prospective nonrandomized cohort study was performed including 30 fetal MMC cases. The first 15 cases (group 1) received magnesium sulfate according to the MOMS protocol. In the following 15 cases (group 2), magnesium sulfate was substituted by atosiban...
August 17, 2017: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/28707771/effect-of-vaginal-progesterone-in-tocolytic-therapy-during-preterm-labor-in-twin-pregnancies-secondary-analysis-of-a-placebo-controlled-randomized-trial
#10
Wagner R Hernandez, Rossana P V Francisco, Roberto E Bittar, Ursula T Gomez, Marcelo Zugaib, Maria L Brizot
AIM: Our aim was to investigate the effect of the prophylactic use of vaginal progesterone on the latency period from the initiation of tocolytic therapy to delivery in twin pregnancies with preterm labor. METHODS: This study was a secondary analysis of a randomized, double-blind, placebo-controlled trial of twin pregnancies in mothers who were exposed to a 200 mg vaginal progesterone ovule or a placebo ovule daily from 18 to 34 weeks gestation. Patients who were administered tocolysis with Atosiban because of preterm labor were included...
July 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28672758/the-misoprostol-vaginal-insert-compared-with-oral-misoprostol-for-labor-induction-in-term-pregnancies-a-pair-matched-case-control-study
#11
Moritz Döbert, Aleke Brandstetter, Wolfgang Henrich, Tamina Rawnaq, Hendrik Hasselbeck, Timm Fabian Döbert, Larry Hinkson, Peter Schwaerzler
AIM: To compare the efficacy and safety of the misoprostol vaginal insert (MVI) with an off-label use of oral misoprostol (OM). METHODS: Pair-matched case-control study comparing the induction of labor with a retrievable MVI to OM. The primary outcomes were the time from induction to delivery and the cesarean section rate. Secondary outcomes included uterine tachysystole, tocolysis, fetal scalp blood testing, meconium-stained amniotic fluid, umbilical arterial pH, and Apgar score...
June 26, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28594783/progestogens-for-maintenance-tocolysis-in-women-with-a-short-cervix-a-randomized-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
Fabio Facchinetti, Patrizia Vergani, Mariarosaria Di Tommaso, Luca Marozio, Barbara Acaia, Roberto Vicini, Lucrezia Pignatti, Anna Locatelli, Marina Spitaleri, Chiara Benedetto, Barbara Zaina, Roberto DʼAmico
OBJECTIVE: To assess the efficacy of progestogens for maintenance tocolysis in women undelivered after their first preterm labor episode. METHODS: Women with singleton pregnancies between 22 0/7 and 31 6/7 weeks of gestation with arrested preterm labor and a cervical length 25 mm or less at hospital discharge were eligible. Patients with a previous preterm birth were excluded. In a randomized controlled trial conducted in five university hospitals, women were randomized to receive vaginal progesterone (200 mg per day) or intramuscular 17α-hydroxyprogesterone caproate (341 mg per week) or to an observation groups (control group)...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28484835/effectiveness-of-the-contemporary-treatment-of-preterm-labor-a-comparison-with-a-historical-cohort
#13
Philipp Wagner, Jiri Sonek, Harald Abele, Loefler Sarah, Markus Hoopmann, Sara Brucker, Qinging Wu, Karl Oliver Kagan
OBJECTIVE: To compare the effectiveness of contemporary treatment of preterm labor to a historical cohort. STUDY DESIGN: Retrospective matched case-control study to compare the outcomes of patients that were treated for preterm labor at the University Hospital of Tuebingen, Germany in 2014/2015 (current treatment cohort) and 2006/2007 (historical cohort). The study included women with singleton gestations who were admitted with the diagnosis of preterm labor between 24 + 0 and 34 + 0 weeks' gestation and a cervical length of ≤15 mm...
July 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28412086/tocolysis-after-preterm-premature-rupture-of-membranes-and-neonatal-outcome-a-propensity-score-analysis
#14
Elsa Lorthe, François Goffinet, Stéphane Marret, Christophe Vayssiere, Cyril Flamant, Mathilde Quere, Valérie Benhammou, Pierre-Yves Ancel, Gilles Kayem
BACKGROUND: There are conflicting results regarding tocolysis in cases of preterm premature rupture of membranes. Delaying delivery may reduce neonatal morbidity because of prematurity and allow for prenatal corticosteroids and, if necessary, in utero transfer. However, that may increase the risks of maternofetal infection and its adverse consequences. OBJECTIVE: The objective of the study was to investigate whether tocolytic therapy in cases of preterm premature rupture of membranes is associated with improved neonatal or obstetric outcomes...
August 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28391733/antenatal-magnesium-sulfate-for-both-tocolysis-and-fetal-neuroprotection-in-premature-rupture-of-the-membranes-before-32-weeks-gestation
#15
Eun Jung Jung, Jung Mi Byun, Young Nam Kim, Kyung Bok Lee, Moon Su Sung, Ki Tae Kim, Jong Beom Shin, Dae Hoon Jeong
OBJECTIVE: We aimed to assess the impact of antenatal MgSO4 therapy given to women with PPROM before 32 weeks' gestation on latency, maternal outcomes, perinatal outcomes, and neurodevelopmental outcomes. METHODS: We undertook a retrospective cohort observational study of 184 singleton pregnancies complicated by PPROM at 23°-316 weeks who were hospitalized and received magnesium therapy for tocolysis (MgSO4 group) or did not receive tocolytic therapy (no MgSO4 group) between 2005 and 2013...
April 26, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28333939/maintenance-nifedipine-therapy-for-preterm-symptomatic-placenta-previa-a-randomized-multicenter-double-blind-placebo-controlled-trial
#16
RANDOMIZED CONTROLLED TRIAL
Eric Verspyck, Claire de Vienne, Charles Muszynski, Michael Bubenheim, Isabella Chanavaz-Lacheray, Michel Dreyfus, Philippe Deruelle, Jacques Benichou
OBJECTIVE: To assess the impact of maintenance nifedipine therapy on pregnancy duration in women with preterm placenta previa bleeding. METHODS: PPADAL was a randomized, double-blind, placebo-controlled trial conducted between 05/2008 and 05/2012 in five French hospitals. The trial included 109 women, aged ≥ 18 years, with at least one episode of placenta previa bleeding, intact membranes and no other pregnancy complication, at gestational age 24 to 34 weeks and after 48 hours of complete acute tocolysis...
2017: PloS One
https://www.readbyqxmd.com/read/28301889/geburtshilfe-an%C3%A3-sthesie-bei-exit-prozedur
#17
REVIEW
Alexander Torossian
The ex utero intrapartum treatment (EXIT) procedure is performed as a part of an extended caesarean section for example to treat fetal airway disorders. For treatment, optimal uterine relaxation is necessary, however utero-placental supply of the fetus has to be guaranteed as well. "Balanced" anesthesia, tocolysis and tight maternal arterial blood pressure control are recommended. Standard fetal monitoring comprises pulse oxymetry and echocardiography. The article describes the physiology and anesthestic goals of the EXIT procedure, discusses alternative anesthesia techniques and gives an outlook on emerging progress...
March 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28210482/delayed-interval-delivery-can-save-the-second-twin-evidence-from-a-systematic-review
#18
REVIEW
S Feys, Y Jacquemyn
BACKGROUND: In case of preterm birth in twins, it is not well established if the second twin benefits from a delayed-interval delivery. OBJECTIVE: The main objective of this systematic review is to evaluate survival benefit of the second twin from delayed interval delivery compared to the first twin. Secondly, we will evaluate the survival benefit of the procedure when performed equal to or after 24 weeks gestational age of the first born. METHODS: Delayed interval delivery was defined as every attempt to perform a delayed interval delivery with at minimum placement of a high ligature of the umbilical cord and a delay of delivery of at least 24 hours...
December 2016: Facts, Views & Vision in ObGyn
https://www.readbyqxmd.com/read/28132012/use-of-magnesium-sulfate-before-32%C3%A2-weeks-of-gestation-a-european-population-based-cohort-study
#19
H T Wolf, L Huusom, T Weber, A Piedvache, S Schmidt, M Norman, J Zeitlin
OBJECTIVES: The use of magnesium sulfate (MgSO4) in European obstetric units is unknown. We aimed to describe reported policies and actual use of MgSO4 in women delivering before 32 weeks of gestation by indication. METHODS: We used data from the European Perinatal Intensive Care in Europe (EPICE) population-based cohort study of births before 32 weeks of gestation in 19 regions in 11 European countries. Data were collected from April 2011 to September 2012 from medical records and questionnaires...
January 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28068594/prevention-of-spontaneous-preterm-birth-guidelines-for-clinical-practice-from-the-french-college-of-gynaecologists-and-obstetricians-cngof
#20
REVIEW
Loïc Sentilhes, Marie-Victoire Sénat, Pierre-Yves Ancel, Elie Azria, Guillaume Benoist, Julie Blanc, Gilles Brabant, Florence Bretelle, Stéphanie Brun, Muriel Doret, Chantal Ducroux-Schouwey, Anne Evrard, Gilles Kayem, Emeline Maisonneuve, Louis Marcellin, Stéphane Marret, Nicolas Mottet, Sabine Paysant, Didier Riethmuller, Patrick Rozenberg, Thomas Schmitz, Héloïse Torchin, Bruno Langer
In France, 60,000 neonates are born preterm every year (7.4%), half of them after the spontaneous onset of labor. Among preventable risk factors of spontaneous prematurity, only cessation of smoking is associated with decreased prematurity (level of evidence [LE]1). It is therefore recommended (Grade A). Routine screening and treatment of vaginal bacteriosis is not recommended in the general population (Grade A). The only population for which vaginal progesterone is recommended is that comprising asymptomatic women with singleton pregnancies, no history of preterm delivery, and a short cervix at 16-24 weeks of gestation (Grade B)...
March 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
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