Document Detail

The Randomized Nitric Oxide Tocolysis Trial (RNOTT) for the treatment of preterm labor.
MedLine Citation:
PMID:  15467526     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: This study was undertaken to assess the effectiveness of glyceryl trinitrate (GTN) patches in comparison with beta2 sympathomimetics (beta2) for the treatment of preterm labor. STUDY DESIGN: A multicenter, multinational, randomized controlled trial was conducted in tertiary referral teaching hospitals. Women in threatened preterm labor with positive fetal fibronectin or ruptured membranes between 24 and 35 weeks' gestation were recruited and randomly assigned to either beta2 or GTN with rescue beta2 tocolysis if moderate-to-strong contractions persisted at 2 hours. Obstetric and neonatal outcomes were assessed. RESULTS: Two hundred thirty-eight women were recruited and randomly assigned, 117 to beta2 and 121 to GTN. On a strict intention-to-treat basis, there was no significant difference in the time to delivery using Kaplan-Meier curves (P = .451). At 2 hours, 27% of women receiving beta2 had moderate or stronger contractions compared with 53% in the GTN group (P < .001). This led to 35% of women in the GTN group receiving rescue treatment. If delivery or requirement for beta2 rescue are regarded as treatment failure, then a significant difference was observed between the 2 arms (P = .0032). There were no significant differences in neonatal outcomes. CONCLUSION: GTN is a less efficacious tocolytic compared with ss2 sympathomimetics.
A Bisits; G Madsen; M Knox; A Gill; R Smith; G Yeo; K Kwek; M Daniel; T N Leung; K Cheung; T Chung; I Jones; J Toohill; D Tudehope; W Giles
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  191     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-10-06     Completed Date:  2004-11-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  683-90     Citation Subset:  AIM; IM    
The Mothers and Babies Research Centre, Faculty of Medicine and Health Sciences, The University of Newcastle, Australia.
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MeSH Terms
Adrenergic beta-Agonists / therapeutic use
Delivery, Obstetric
Gestational Age
Nitroglycerin / adverse effects,  therapeutic use*
Obstetric Labor, Premature / drug therapy*
Pregnancy Outcome
Receptors, Adrenergic, beta-2 / agonists
Time Factors
Tocolytic Agents / adverse effects,  therapeutic use*
Treatment Outcome
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Receptors, Adrenergic, beta-2; 0/Tocolytic Agents; 55-63-0/Nitroglycerin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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