Different impacts of various tocolytic agents on increased risk of postoperative hemorrhage in preterm labor women undergoing Cesarean delivery

Lee, Hua-Lin; Lu, Kuo-Ching; Foo, Jossen; Huang, I-Tao; Fan, Yen‐Chun; Tsai, Pei‐Shan; Huang, Chun-Ta

doi:10.1097/md.0000000000023651

Cited by 4 publications

(2 citation statements)

References 31 publications

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“…In contrast to the findings in rodents, the use of opioids in humans has been associated with respiratory depression, altered neonatal vitality scores, higher mortality, and problems in mother–offspring interaction due to hypnotic effects [ 53 ]. There have also been reports of a tocolytic effect on myometrial activity, suggesting that this could affect maternal performance at birth [ 54 , 55 , 56 ]. These findings are corroborated by a study in baboons ( Papio anubis ) in their third trimester of gestation (140–150 days).…”

Section: Opioidsmentioning

confidence: 99%

Analgesia during Parturition in Domestic Animals: Perspectives and Controversies on Its Use

Mota-Rojas

Velarde

Marcet-Rius

et al. 2022

Animals

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This article analyzes the physiological role of pain during parturition in domestic animals, discusses the controversies surrounding the use of opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local analgesics as treatments during labor, and presents the advantages and disadvantages for mother and offspring. Labor is a potentially stressful and painful event, due to the contractions that promote expulsion of the fetus. During labor, neurotransmitters such as the prostaglandins contribute to the sensitization of oxytocin receptors in the myometrium and the activation of nociceptive fibers, thus supporting the physiological role of pain. Endogenously, the body secretes opioid peptides that modulate harmful stimuli and, at the same time, can inhibit oxytocin’s action in the myometrium. Treating pain during the different stages of parturition is an option that can help prevent such consequences as tachycardia, changes in breathing patterns, and respiratory acidosis, all of which can harm the wellbeing of offspring. However, studies have found that some analgesics can promote myometrial contractility, increase expulsion time, affect fetal circulation, and alter mother–offspring recognition due to hypnotic effects. Other data, however, indicate that reducing the number of uterine contractions with analgesics increases their potency, thus improving maternal performance. Managing pain during labor requires understanding the tocolytic properties of analgesics and their advantages in preventing the consequences of pain.

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Section: Opioidsmentioning

confidence: 99%

Analgesia during Parturition in Domestic Animals: Perspectives and Controversies on Its Use

Mota-Rojas

Velarde

Marcet-Rius

et al. 2022

Animals

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“…However, unnecessary intervention can cause adverse maternal and neonatal outcomes. For example, tocolytics can cause palpitations, pulmonary edema, myocardial infarction, arterial hypotension, chorioamnionitis, and post-operative hemorrhage [17,18], and antenatal corticosteroids are associated with adverse neurodevelopmental outcomes in children [19].…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a nomogram for predicting preterm birth among pregnant women who had Antenatal care follow-up at University of Gondar Comprehensive Specialized Hospital using maternal and fetal characteristics: Retrospective follow-up study

Gessese,

Geremew,

Nigatu

et al. 2024

Preprint

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Background: - Preterm complications are the leading cause of death in children under the age of 5. Estimating the probability of a pregnant woman being at risk of preterm delivery would help to initiate preventive measures to reduce preterm delivery. The available risk prediction models used non-feasible predictors and did not consider fetal characteristics. This study aimed to develop an easily interpretable nomogram based on maternal and fetal characteristics. Methods: - A retrospective follow-up study was conducted with a total of 1039 pregnant women who were enrolled from June 1, 2021, to June 1, 2022, at the University of Gondar Comprehensive Specialized Hospital. Stata version 17 was used for data analysis. Important predictors were selected by the least absolute shrinkage and selection operator and entered into multivariable logistic regression. Statistically and clinically significant predictors were used for the nomogram’s development. Model performance was assessed by the area under the receiver operating curve (AUROC) and calibration plot. Internal validation was done through the bootstrapping method, and decision curve analysis was performed to evaluate the clinical and public health impacts of the model Result: - The incidence proportion of preterm birth among pregnant women was 14.15% (95%CI: 12.03, 16.27). Antepartum hemorrhage, preeclampsia, polyhydramnios, anemia, human immune virus, malpresentation, premature rupture of membrane, and diabetic mellitus were used to develop a nomogram. The nomogram had a discriminating power AUROC of 0.79 (95% CI: 0.74, 0.83) and 0.78 (95% CI: 0.73, 0.82) on the development and validation sets. The calibration plots exhibited optimal agreement between the predicted and observed values; the Hosmer-Lemeshow test yielded a P-value of 0.602. The decision curve analysis revealed that the nomogram would add net clinical benefits at threshold probabilities less than 0.8. Conclusion: - The developed nomogram had good discriminative performance and good calibration. Using this model could help identify pregnant women at a higher risk of preterm delivery and provide interventions like corticosteroid and progesterone administration, cervical cerclage, and nutritional support.

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Acute tocolysis for intrapartum nonreassuring fetal status: how often does it prevent cesarean delivery? A systematic review and meta-analysis of randomized controlled trials

Xodo

Heus

Berghella

et al. 2022

American Journal of Obstetrics & Gynecology MFM

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Different impacts of various tocolytic agents on increased risk of postoperative hemorrhage in preterm labor women undergoing Cesarean delivery

Cited by 4 publications

References 31 publications

Analgesia during Parturition in Domestic Animals: Perspectives and Controversies on Its Use

Analgesia during Parturition in Domestic Animals: Perspectives and Controversies on Its Use

Development and validation of a nomogram for predicting preterm birth among pregnant women who had Antenatal care follow-up at University of Gondar Comprehensive Specialized Hospital using maternal and fetal characteristics: Retrospective follow-up study

Acute tocolysis for intrapartum nonreassuring fetal status: how often does it prevent cesarean delivery? A systematic review and meta-analysis of randomized controlled trials

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