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Tocolytic

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1541. Randomized trial of antibiotics in addition to tocolytic therapy to treat preterm labor. (PubMed)

Randomized trial of antibiotics in addition to tocolytic therapy to treat preterm labor. The objective of this study was to assess whether antibiotic therapy plus tocolysis given to women in preterm labor would prolong pregnancy compared with tocolysis alone.A randomized, double-blind trial of intravenous mezlocillin and oral erythromycin therapy vs. placebo was used in addition to tocolysis among women in preterm labor < or =34 weeks gestation with intact membranes. Amniocentesis was performed

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1994 Infectious diseases in obstetrics and gynecology

1542. Premature rupture of the membranes--aggressive versus conservative approach: effect of tocolytic and antibiotic therapy. (PubMed)

Premature rupture of the membranes--aggressive versus conservative approach: effect of tocolytic and antibiotic therapy. The purpose of this randomized, prospective study was to evaluate the efficacy of tocolytic and antibiotic therapy in the prolongation of pregnancy and neonatal outcome in the treatment of premature rupture of the membranes without clinical labor. Delivery was delayed for 48 h, 7 days and beyond 35 weeks of gestation in 87, 39 and 18%, respectively, of patients in the treated

1993 Gynecologic and obstetric investigation

1543. An oxytocin receptor antagonist (atosiban) in the treatment of preterm labor: a randomized, double-blind, placebo-controlled trial with tocolytic rescue. (PubMed)

An oxytocin receptor antagonist (atosiban) in the treatment of preterm labor: a randomized, double-blind, placebo-controlled trial with tocolytic rescue. This study was designed to evaluate the efficacy and safety of the oxytocin receptor antagonist atosiban in the treatment of preterm labor.A multicenter, double-blind, placebo-controlled trial with tocolytic rescue was designed. Five hundred thirty-one patients were randomized to receive, and 501 received, either intravenous atosiban (n = 246 (...) ) or placebo (n = 255), followed by subcutaneous maintenance with the assigned agent. Standard tocolytics as rescue tocolysis were permitted after 1 hour of either placebo or atosiban if preterm labor continued. The primary end point was the time from the start of study drug to delivery or therapeutic failure. Secondary end points were the proportion of patients who remained undelivered and did not receive an alternate tocolytic at 24 hours, 48 hours, and 7 days.No significant difference was found

2000 American journal of obstetrics and gynecology

1544. Randomised, double-blind, placebo controlled pilot study assessing nitroglycerin as a tocolytic. (PubMed)

Randomised, double-blind, placebo controlled pilot study assessing nitroglycerin as a tocolytic. Thirty-three women in preterm labour were randomised in a double-blind fashion to receive either transdermal nitroglycerin (n = 17) or placebo (n = 16). Both groups had significant (P < 0.001) change in the cervix prior to randomisation. The primary outcome measure was delivery within 48 hours of randomisation. Fewer women randomised to nitroglycerin treatment (6/17) were delivered within 48 hours

1999 British journal of obstetrics and gynaecology

1545. Value of maintenance therapy with oral tocolytics: a systematic review. (PubMed)

Value of maintenance therapy with oral tocolytics: a systematic review. The objective was to perform a systematic review of prospective randomized trials evaluating the efficacy of oral tocolytics in the prevention of recurrent preterm labor and its associated complications.A MEDLINE search of English language articles published since 1966 was performed to identify studies of maintenance oral tocolytic therapy. Studies were included in the review which: 1) randomized patients to an oral (...) tocolytic after stabilization with parenteral therapy; 2) reported results for either a placebo or a control group; and 3) included patients with intact membranes only. These studies were analyzed for nine outcomes, including incidence of preterm delivery, incidence of recurrent preterm labor, latency from treatment to delivery, gestational age, birthweight, admission to an intensive care nursery (ICN), incidence of respiratory distress syndrome (RDS), incidence of intraventricular hemorrhage (IVH

1999 The Journal of maternal-fetal medicine

1546. Tocolytics for preterm labor: a systematic review. (PubMed)

Tocolytics for preterm labor: a systematic review. To examine the effectiveness of any tocolytic compared with a placebo or no tocolytic for preterm labor.We checked MEDLINE (1966-1998) and the Cochrane Controlled Trials Register for articles, using the search terms "randomized controlled trial" (RCT), "preterm labor," "tocolysis," "betamimetics," "ritodrine," "terbutaline," "hexaprenaline," "isoxuprine," "prostaglandin synthetase inhibitors," "indomethacin," "sulindac," "calcium channel (...) blockers," "nifedipine," "oxytocin receptor blockers," "atosiban," "nitroglceride," and "magnesium sulfate."We included all RCTs that compared effect of a tocolytic with a placebo or no tocolytic in women in preterm labor, and reported perinatal, neonatal, or maternal outcomes. Studies were excluded if loss to follow-up exceeded 20% of those originally enrolled, or if data were not reported on a per-patient-treated basis. Eighteen of 76 articles retrieved met the inclusion criteria.Two authors

1999 Obstetrics and Gynecology

1547. If tocolytic magnesium sulfate is associated with excess total pediatric mortality, what is its impact? (PubMed)

If tocolytic magnesium sulfate is associated with excess total pediatric mortality, what is its impact? The Magnesium and Neurologic Endpoints Trial was a randomized controlled trial (RCT) done to learn whether or not receiving magnesium sulfate during preterm labor could prevent cerebral palsy. Unexpectedly, in the tocolytic arms of the trial, seven (including one set of twins) of 46 cases assigned to receive magnesium ended in total pediatric mortality (fetal + neonatal + postneonatal (...) ), compared to none of 47 cases assigned to other tocolytics ending in death. The difference between the two treatment arms is highly statistically significant (risk difference 15.2%; 95% confidence interval 4.8, 25.6; P = .006). If this relationship is confirmed by experimentation with animals or through the conduct of a large RCT at other institutions, it is possible that tocolytic magnesium will be found to be associated with the deaths of several thousand newborns in the United States annually

1998 Obstetrics and Gynecology

1548. Thermic effects of tocolytic agents: decreased temperature with magnesium sulfate. (PubMed)

Thermic effects of tocolytic agents: decreased temperature with magnesium sulfate. The effect of the tocolytic agents terbutaline and magnesium sulfate on patients' temperatures was examined. Fifty-two women admitted for preterm labor were randomized to a treatment protocol for one of the two agents. Oral temperatures were measured initially and every two hours during treatment. There was no significant difference between the initial temperature and the lowest temperature recorded during

1987 Obstetrics and Gynecology

1549. Efficacy and side effects of magnesium sulfate and ritodrine as tocolytic agents. (PubMed)

Efficacy and side effects of magnesium sulfate and ritodrine as tocolytic agents. Ritodrine as the first-line drug in the treatment of established preterm labor has been supplanted in some centers by magnesium sulfate. To assess the relative efficacy and rates of side effects of these two agents, 120 patients were randomly assigned to receive one of these two drugs. Patients were included if they had intact membranes and met strict criteria for the definition of labor. In both groups excellent (...) outcome was achieved, with 96.3% and 92.3% of patients receiving ritodrine and magnesium sulfate, respectively, obtaining a delay in delivery of greater than 48 hours. Side effects were comparable in both groups, although they tended to be more serious in the patients receiving ritodrine. In patients receiving both drugs together, the rate of side effects was 77% without a demonstrable benefit over a single agent. We conclude that ritodrine and magnesium sulfate are tocolytics of comparable efficacy

1988 American journal of obstetrics and gynecology

1550. External cephalic version at term: is a tocolytic necessary? (PubMed)

External cephalic version at term: is a tocolytic necessary? This prospective investigation evaluates the benefit of a beta-mimetic tocolytic for external cephalic version. From July 1, 1984 to May 15, 1987, 58 patients who had breech presentations between 37-41 weeks' gestation were considered for external cephalic version. The patients were randomly assigned to one of two groups: tocolytic or no tocolytic. An ultrasound examination, serum alpha-fetoprotein (AFP), Kleihauer-Betke test (...) , and nonstress test (NST) were performed before and after the attempt at version. A version was not attempted if there was evidence of intrauterine growth retardation (IUGR), oligohydramnios, or a nonreactive NST. Patients in the tocolytic group received 200 micrograms/minute of ritodrine hydrochloride for 20 minutes via continuous intravenous infusion before a version was attempted. Twenty of the 30 patients (66.7%) in the tocolytic group and 19 of the 28 patients (67.8%) in the no-tocolytic group had

1987 Obstetrics and Gynecology

1551. KUR-1246, a novel beta(2)-adrenoceptor agonist, as a tocolytic agent. (PubMed)

KUR-1246, a novel beta(2)-adrenoceptor agonist, as a tocolytic agent. To examine the effects of KUR-1246 on oxytocin-induced uterine contractions, the cardiovascular system, and general metabolism of pregnant sheep and their fetuses.At 123-125 days' gestation, ewes (n = 8) were infused with oxytocin (1.0 mU/kg/minute) to induce uterine contractions. One hour later, KUR-1246 was infused for 3 consecutive hours beginning at a dose of 0.001 microg/kg/minute for 30 minutes and increasing stepwise

2002 Obstetrics and Gynecology

1552. In vitro study of tocolytic effect of rofecoxib, a specific cyclo-oxygenase 2 inhibitor. Comparison and combination with other tocolytic agents. (PubMed)

In vitro study of tocolytic effect of rofecoxib, a specific cyclo-oxygenase 2 inhibitor. Comparison and combination with other tocolytic agents. The aim of this work was to study and compare the tocolytic effects of rofecoxib with indomethacin, ritodrine, nicardipine and atosiban. We also studied the combination of rofecoxib with each agent.In vitro animal experimental study.Non-selective cyclo-oxygenase (COX) inhibitors have potent tocolytic effect. However, they also have major fetal side (...) effects that seem to be due to COX-1 inhibition. A specific COX-2 inhibitor could be a potent tocolytic agent with less fetal toxicity.Myometrial strips from pregnant Wistar rats at 18 days of gestation.Isometric tension was recorded from 112 pregnant rat myometrial strips in vitro. Strips were exposed to increase molar concentration of one drug or combination.Contractile activity was assessed by calculating the area under the curve, to obtain a dose-response curve of each drug. EC50 and mean maximal

2002 BJOG

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