Tocolytic effectiveness of nifedipine versus ritodrine and follow-up of newborns: a randomised controlled trial.
| Autor: | Van De Water M; Department of Obstetrics and Gynaecology, Máxima Medical Centre, The Netherlands. m.vandewater@alumni.unimaas.nl, Kessel ET, De Kleine MJ, Oei SG |
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| Jazyk: | angličtina |
| Zdroj: | Acta obstetricia et gynecologica Scandinavica [Acta Obstet Gynecol Scand] 2008; Vol. 87 (3), pp. 340-5. |
| DOI: | 10.1080/00016340801913189 |
| Abstrakt: | Background: Several studies have demonstrated the superior tocolytic effectiveness of nifedipine over ritodrine. Only 1 trial conducted a long-term follow-up of newborns and found no difference in psychosocial and motor functioning. In a randomised, multicentre trial, we compared the tocolytic effectiveness of nifedipine and ritodrine and included a long-term follow-up of the newborns after 2 years of age. Methods: Patients with imminent preterm labour were randomised and received either nifedipine or ritodrine. Side-effects, tocolytic effectiveness and neonatal outcome were studied. Development of the children was studied after the age of 2 years by a parental questionnaire. Results: Ninety-three patients were included. Birth was postponed for an average of 4.3 weeks in the ritodrine group and 5.0 weeks in the nifedipine group (p=0.4). Patients who received ritodrine experienced significantly more side-effects compared to patients who received nifedipine (29 versus 4%, p<0.05). No significant differences were found in either group for average birth weight, Apgar scores after 1 min, neonatal intensive care unit (NICU) admission and neonatal complications. Parental questionnaires after 2 years had a response rate of 70%. Two-thirds of the children had developed normally in both groups. In both groups, only a few children were severely retarded (n=4). No significant differences in development were found between the 2 groups. Conclusions: Both nifedipine and ritodrine proved effective tocolytic drugs, however ritodrine caused significantly more maternal side-effects. Neonatal outcome and long-term development after 2 years of age were not significantly different. We favour nifedipine over ritodrine as a tocolytic drug. |
| Databáze: | MEDLINE |
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