Efficacy and safety of indomethacin versus ritodrine in the management of preterm labor: a randomized study
Article Abstract:
Preterm births are associated with poor fetal outcome, particularly when delivery occurs before the 32nd week of pregnancy. Drugs that slow the progression of labor are termed tocolytic agents. Currently, the only tocolytic agent approved by the Food and Drug Administration (FDA) is ritodrine hydrochloride. Since ritodrine has many side effects it is not widely used. Prostaglandins, hormone-like substances involved in mediating many physiological processes, cause uterine contractions, soften the cervix, and promote cervical dilation. Indomethacin, a drug that inhibits the action of prostaglandins, safely and effectively slows premature labor. The efficacy and safety of indomethacin in controlling preterm labor was compared with ritodrine. To determine which drug was the most effective tocolytic agent, 106 pregnant women having progressive preterm labor and intact fetal membranes at 32 weeks of pregnancy were assigned to receive either ritodrine (54 patients) or indomethacin (52 patients). Both agents similarly controlled labor contractions and delayed delivery. Patients receiving ritodrine experienced side effects such as abnormal heart rhythms, chest pain, rapid heart beats and low blood pressure. These symptoms were serious enough to discontinue therapy in 24 percent of the patients. Although patients receiving indomethacin reported no serious side effects, a decreased amount of amniotic fluid was noted in six patients. No adverse effects were seen among the infants born to either group. Blood glucose levels were slightly higher in infants born to women who received ritodrine. Ritodrine was 17 times more expensive than indomethacin. Indomethacin is a safe, effective and inexpensive tocolytic agent. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1989
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A randomized comparison of assisted vaginal delivery by obstetric forceps and polyethylene vacuum cup
Article Abstract:
During vaginal delivery of a newborn infant, the doctor can assist the delivery using metal forceps or a vacuum (suction) cup that is placed on the infants head. Both of these methods have risks. The forceps can injure the infant's face, while the vacuum cup can damage the scalp and cause retinal hemorrhage (bleeding in the eyes). Therefore, a study was performed to evaluate the safety and effectiveness of forceps and vacuum cups for assisting vaginal delivery. The study included 99 women who had been pregnant for at least 35 weeks. All of the infants were delivered head first, using either forceps (51 infants) or vacuum cups (48 infants). Twenty-four hours after delivery, the infants were examined for skull damage using ultrasound and 24 hours later were examined for eye damage. There were no significant differences in birth weight, length or head size between the two groups. Seventy-eight percent of the forceps-assisted deliveries and 83 percent of the vacuum-assisted deliveries were successful. None of the infants had intraventricular hemorrhage (bleeding inside the brain). Retinal hemorrhage occurred in 38 percent of the infants delivered using a vacuum cup and in 17 percent of those delivered using forceps. There were no significant differences in maternal or infant outcome between the two groups. It is concluded that both methods are equally safe and effective for assisting vaginal delivery. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1991
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Use of ampicillin and corticosteroids in premature rupture of membranes: a randomized study
Article Abstract:
The effectiveness of corticosteroids (antiinflammatory steroids) and ampicillin (an infection-fighting antibiotic), administered before birth was investigated in the treatment of premature rupture of membranes, a condition caused by the rupture of the membrane enveloping a fetus one or more hours before the onset of labor. The rupture increases the risk of infection and disease in the fetus. One hundred sixty-five patients received various combinations of one or both of the drugs or nothing. Incidences of respiratory distress syndrome, a condition of infants marked by difficulty breathing, of infant lung disease and other disorders were reduced in patients who received corticosteroids before labor compared to those who had not received the treatment. Infants of mothers who received the antibiotic ampicillin developed fewer cases of chorioamnionitis, the inflammation of fetal membrane, and other infections, than those who had not received the drug.
Publication Name: Obstetrics and Gynecology
Subject: Health
ISSN: 0029-7844
Year: 1989
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- Abstracts: Randomized comparative trial of indomethacin and ritodrine for the long-term treatment of preterm labor. Double-blind, randomized, controlled trial of atosiban and ritodrine in the treatment of preterm labor: a multicenter effectiveness and safety study
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