Author/Editor		Rebolj, Marija; Toff, Renata; Cerar, Vasilij; Novak-Antolič, Živa
Title		Preliminary report: nitroglycerin patch for tocolysis in threatened preterm labour
Translated title		Preliminarno poročilo: nitroglicerinski obliž za tokolizo pri grozečem prezgodnjem porodu
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 68, št. 3
Publication year		1999
Volume		str. 145-50
Language		eng
Abstract		Background. Prematurity is the main cause of perinatal morbidity and mortality in Slovenia as well as elsewhere in the world. In threatening preterm labour worldwide is tried to prolong pregnancy with tocolysis for at least 24-48 hours, but it would be desirable to postpone the delivery to 36 6/7 weeks of gestation. The purpose of this prospective observational preliminar study was to estimate the efficiency of nitroglycerin patch as a tocolytic agent, its subjective side effects with mothers and to compare the results with those of ritodrine and magnesium sulfate in our Department of Obstetrics and Gynaecology. Methods. Thirty-one pregnant women, who in certain time fulfilled certain criteria, entered the study. They were divided into three groups regarding the tocolytic agent used. Selection of the tocolytic agent was not accidental. We observed the patients from the beginning of tocolysis until the delivery. The achieved period of prolongation, gestational age at birth, birth weight. Apgar score at the first and fifth minute, reappearance of threatening preterm labour signs, proportion of deliveries after 36 6/7 weeks of pregnancy ans side effects were statistically evaluated. Results. Significant difference was found among groups with singletons regarding the number of days, for which the pregnancy was extended. This number was the highest in the nitroglycerin patch group with 9.3 more days compared to magnesium sulfate group and 40.6 more days compared to the ritodrine group. Nitroglycerine patch is more effective as magnesium sulfate or ritodrine. In these three groups, significant difference was found when comparing gestational ages at birth. (Abstract truncated at 2000 characters).
Summary		Izhodišča. Prezgodnji porod je eden glavnih dejavnikov, ki povzročajo večjo perinatalno obolevnost in umrljivost. Vsaj nekoliko ju lahko zmanjšamo s preprečevanjem prezgodnjega poroda in prekinitvijo že pojavljajočih se prezgodnjih popadkov. Tokolitiki, ki se uporabljajo v Sloveniji (ritodrin, magnezijev sulfat), imajo številne neugodne stranske učinke na nosečnico. Poročilo klinične študije o učinkovitosti nitroglicerinskega obliža kot tokolitika, kjer je aktivna komponenta dušikov oksid, nas je spodbudila, da smo ga uvedli na Klinični oddelek za perinatologijo Ginekološke klinike Kliničnega centra v Ljubljani. Hoteli smo ugotoviti njegovo učinkovitost in morebitne prednosti pred ostalima uporabljenima tokolitikoma. Metode. V študijo so bile vključene nosečnice, hospitalizirane zaradi grožečega prezgodnjega poroda na Kliničnem oddelku za perinatologijo. Sodelovanje vključenih nosečnic je temeljilo na pisni privolitvi po razlagi in posvetu. Z raziskavo smo začeli 10.4.1995 ob vključitvi prve bolnice, končali smo jo 19.9.1996, ko je rodila še zadnja porodnica, vključena v študijo. Študijo je odobrila Republiška strokovna komisija za medicinsko etiko (št. 197/1994). Vključenih je bilo 31 nosečnic, nosečih 23 4/7 do vključno 34 3/7 tedna (gestacija določena z ultrazvočnim pregledom do 20. tedna) in s popadki, vidnimi na kardiokartografskem zapisu, snemanjem 40 minut, in/ali s skrajšanim in zmehčanim materničnim vratom in /ali s subjektinimi občutki (tiščanje navzdol, trd in napet trebuh, ledvena bolečina, krči, podobni menstrualnim, zbadajoče bolečine v trebuhu). (Abstract truncated at 2000 characters).
Descriptors		LABOR, PREMATURE TOCOLYTIC AGENTS NITRIC OXIDE PREGNANCY, PROLONGED RITODRINE MAGNESIUM SULFATE INDOMETHACIN