Document Detail

The effects of the tocolytics atosiban and nifedipine on fetal movements, heart rate and blood flow.
MedLine Citation:
PMID:  19479644     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The choice of first-line tocolytic agent is a topic of worldwide debate. The oxytocin receptor antagonist atosiban and the calcium antagonist nifedipine appear to be effective in postponing delivery. However, information is lacking on their possible effects on the fetal biophysical profile. OBJECTIVE: To study the direct fetal effects of tocolysis with atosiban or nifedipine combined with a course of betamethasone. METHOD: We performed a randomised controlled study including women with preterm labour requiring tocolytic treatment. Primary outcome measures were the effects on fetal heart rate (FHR) and its variation. Secondary endpoints were the effects on fetal movement and blood flow (pulsatility index - PI) of the umbilical (UA) and medial cerebral arteries (MCA). RESULTS: One-hour recordings of FHR and fetal movements were made on each of five successive days (days 0-4). Fetal blood flow velocity patterns were studied daily by Doppler ultrasound. Baseline characteristics of 31 women who had not delivered at day 0 and needed no escape tocolysis did not differ between the study groups. Multilevel analysis showed no significant effect of either tocolytic on FHR and movement parameters over the 5-day study period. The use of tocolytics also did not significantly alter the time courses of PI-values for UA (p = 0.37) and MCA (p = 0.62). CONCLUSION: This study demonstrates for the first time the direct effects of atosiban on fetal movement, heart rate and blood flow. Tocolysis with either atosiban or nifedipine combined with betamethasone administration appears to have no direct fetal adverse effects.
Roel de Heus; Eduard J H Mulder; Jan B Derks; Gerard H A Visser
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians     Volume:  22     ISSN:  1476-4954     ISO Abbreviation:  J. Matern. Fetal. Neonatal. Med.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-16     Completed Date:  2009-08-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101136916     Medline TA:  J Matern Fetal Neonatal Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  485-90     Citation Subset:  IM    
Department of Woman and Baby, University Medical Centre Utrecht, Utrecht, The Netherlands.
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MeSH Terms
Betamethasone / administration & dosage
Drug Combinations
Fetal Blood / drug effects
Fetal Movement / drug effects*
Heart Rate, Fetal / drug effects*
Infant, Newborn
Nifedipine / administration & dosage,  therapeutic use*
Placental Circulation / drug effects*
Pregnancy Outcome
Premature Birth / prevention & control*
Tocolytic Agents / administration & dosage,  therapeutic use
Vasotocin / administration & dosage,  analogs & derivatives*,  therapeutic use
Reg. No./Substance:
0/Drug Combinations; 0/Tocolytic Agents; 21829-25-4/Nifedipine; 378-44-9/Betamethasone; 9034-50-8/Vasotocin; 90779-69-4/atosiban

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