Acute tocolysis

Chandraharan, Edwin; Arulkumaran, Sabaratnam

doi:10.1097/01.gco.0000162184.45854.88

Cited by 39 publications

(9 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition to their use in MI and ischemia, intravenous or oral nitrates have been used during pregnancy to treat hypertension (132), to treat acute tocolysis (133), and for relaxation of the uterus in post-partum patients with retained placenta (134). Use of transdermal nitroglycerin for the treatment of preterm labor was not associated with any affect on fetal or uterine perfusion (135).…”

Section: Organic Nitrates (Risk Category B: Nitroglycerin;mentioning

confidence: 99%

Acute Myocardial Infarction Associated With Pregnancy

Roth¹,

Elkayam²

2008

Journal of the American College of Cardiology

346

278

View full text Add to dashboard Cite

Acute myocardial infarction (AMI) during pregnancy or the early post-partum period is rare but has been shown to be associated with poor maternal as well as fetal outcome. Major changes in both diagnosis and treatment of AMI in the nonpregnant patient have lead to improved outcome which may also affect pregnant patients. The purpose of this paper is to review available information related to the pathophysiology and clinical profile and provide recommendations for the diagnosis and management of AMI occuring during pregnancy and the early post-partum period.

show abstract

Section: Organic Nitrates (Risk Category B: Nitroglycerin;mentioning

confidence: 99%

Acute Myocardial Infarction Associated With Pregnancy

Roth¹,

Elkayam²

2008

Journal of the American College of Cardiology

346

278

View full text Add to dashboard Cite

show abstract

“…This may be explained by the fact that in infection there is an increased metabolic demand leading to higher oxygen consumption compared to noninfected cases . Therefore, chorioamnionitis may lead to accelerated fall in pH during labor resulting in umbilical cord metabolic acidosis at birth …”

Section: Discussionmentioning

confidence: 99%

Intrapartum cardiotocography patterns observed in suspected clinical and subclinical chorioamnionitis in term fetuses

Galli

Dall’Asta

Whelehan

et al. 2019

J of Obstet and Gynaecol

Self Cite

View full text Add to dashboard Cite

Aim: To evaluate the cardiotocography (CTG) features observed in suspected intrapartum chorioamnionitis in term fetuses according to the recently suggested criteria for the pathophysiological interpretation of the fetal heart rate and their correlation with perinatal outcomes. Methods: Retrospective analysis of nonconsecutive CTG traces. 'CTG chorioamnionitis' was diagnosed either based on a persistent rise in the baseline for the given gestation or on a persistent increase in the baseline fetal heart rate during labor >10% without preceding CTG signs of hypoxia and in the absence of maternal pyrexia. Perinatal outcomes were compared among cases with no sign of chorioamnionitis, in those with only CTG features suspicious for chorioamnionitis and in those who developed clinical chorioamnionitis. Results: Two thousand one hundred and five CTG traces were analyzed. Of these, 356 fulfilled the criteria for "CTG chorioamnionitis". Higher rates of Apgar <7 at 1 and 5 min (21.6% vs 9.0% and 9.8% vs 2.0%, respectively, P < 0.01 for both) and lower umbilical artery pH (7.14 AE 0.11 vs 7.19 AE 0.11, P < 0.01) and an over fivefold higher rate of neonatal intensive care unit admission (16.6% vs 2.9%, P < 0.01) were noted in the 'CTG chorioamnionitis' group. Differences in the incidence of abnormal CTG patterns were noted between cases who eventually had clinical evidence of chorioamnionitis (89/356) and those showing CTG features suspicious for chorioamnionitis in the absence of clinical evidence of chorioamnionitis (267/356). Conclusion: Intrapartum CTG features of suspected chorioamnionitis are associated with adverse perinatal outcomes.

show abstract

“…Pulmonary oedema may be avoided by careful fluid therapy, not combining tocolytics and maintaining the maternal heart rate below 120 b.p.m. β‐mimetics should not be given to patients with pre‐existing cardiac disease such as arrythmias and poorly controlled thyroid hyperactivity 9 …”

Section: Tocolytic Substancesmentioning

confidence: 99%

Anaesthesiological considerations on tocolytic and uterotonic therapy in obstetrics

Vercauteren

Palit

Soetens

et al. 2009

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

Aim: Significant side effects of tocolytic and uterotonic substances may be of concern to the anaesthesiologist. Recently, new drugs have been introduced having less side effects for both the mother and the neonate. Methods: A literature search was undertaken mainly focusing on meta-analyses, to review the possible side effects that might affect the course of anaesthesia and to suggest which precautions should be considered to prevent the occurrence of significant interactions with anaesthetic manipulations and drugs. Results: Magnesium sulphate has a proven benefit in lowering systolic blood pressure and preventing the occurrence of eclampsia, but not as a tocolytic. b-adrenergic agonists are being abandoned due to the availability of tocolytic agents causing less side effects. Calcium channel blockers (CCB) are frequently used but can cause major maternal cardiovascular complications. Nitroglycerin seems to be appreciated as an acute tocolytic rather than a routine substance during pre-term labour. Cyclo-oxygenase-2 inhibitors are still under investigation but their tocolytic benefit is questionable mainly due to foetal side effects. Atosiban is considered the first-choice tocolytic. With respect to oxytocic drugs, oxytocine, prostaglandines and methylergometrine may all cause serious side effects especially when combined. The cardiovascular side effects of prostaglandins and methylergometrine can be lifethreatening. Both oxytocin and carbetocin have a rather low risk for maternal complications. Conclusion: Atosiban and CCB are at least as effective tocolytic agents as b-mimetics but have significantly less side effects. Magnesium sulphate can cause neuromuscular blockade, especially when combined with CCB. Concerning oxytocic agents, short-acting oxyctocin and long-acting carbetocin have the least side effects as compared with prostaglandins and methylergometrine.

show abstract

Acute tocolysis

Cited by 39 publications

References 31 publications

Acute Myocardial Infarction Associated With Pregnancy

Acute Myocardial Infarction Associated With Pregnancy

Intrapartum cardiotocography patterns observed in suspected clinical and subclinical chorioamnionitis in term fetuses

Anaesthesiological considerations on tocolytic and uterotonic therapy in obstetrics

Contact Info

Product

Resources

About