A study on intrauterine fetal resuscitation with terbutaline

Patriarco, Michael; Viechnicki, Bruce M.; Hutchinson, Thomas; Klasko, Stephen K.; Yeh, Shih-Ching

doi:10.1016/s0002-9378(87)80178-3

Cited by 35 publications

(28 citation statements)

References 6 publications

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“…10 Tocolysis is rarely used currently because clinicians assume that the origin of the fetal dis-tress arises in the placenta. If, as suggested by these data, myometrial contractility were a factor in fetal distress, then further consideration should be given to tocolysis using b 2 -sympathomimetics, [16][17][18][19] magnesium sulphate 20 or nitroglycerin. [19][20][21][22]…”

Section: Discussionmentioning

confidence: 99%

In vitro myometrial contractility reflects indication for caesarean section

Quenby

Matthew

Zhang

et al. 2011

BJOG

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Section: Discussionmentioning

confidence: 99%

In vitro myometrial contractility reflects indication for caesarean section

Quenby

Matthew

Zhang

et al. 2011

BJOG

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“…No extraña pues, que al producir una relajación uterina farmacológica, el feto pueda recuperar su estado de oxemia basal y mejorar así las alteraciones que se produzcan en el MEFI. Hay suficiente evidencia para afirmar que la tocolisis intraparto, es una maniobra de resucitación intrauterina efectiva, en mejorar las alteraciones del MEFI con una efectividad promedio cercana al 80% (27)(28)(29). Esta efectividad está claramente demostrada para ß-miméticos y Nitroglicerina, no existiendo estudios suficientes que confirmen a Atosiban como tocolí-tico efectivo para resucitación intrauterina frente a un MEFI alterado.…”

Section: Discussionunclassified

“…En 1998, Kulier y Hofmeyr (26), llevaron a cabo una revisión sistemática en la base de datos Cochrane, considerando 3 estudios randomizados controlados que utilizaron ß-miméticos como maniobra de resucitación intrauterina. El primer estudio (27), comparó Terbutalina vs no tratamiento, mejorando el MEFI en el 91% de las pacientes tratadas con Terbutalina y 0% en el grupo de no tratamiento (RR 11,11; IC 95% 1,7-100). El segundo estudio (28), comparó Terbutalina vs Sulfato de Magnesio, logrando mejoría del MEFI en 91,3% de las pacientes tratadas con Terbutalina y 69,6% de las pacientes tratadas con Sulfato de Magnesio.…”

Section: Tocolisis Inrapartounclassified

Efectividad De La Hiperoxigenación Materna Y Tocolisis Aguda en Monitoreo Electrónico Fetal Intraparto Alterado

Nuñez¹,

2009

Rev. chil. obstet. ginecol.

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RESUMENEl trabajo de parto es un evento de riesgo para hipoxia fetal aguda, lo que puede detectarse en alteraciones del Monitoreo Electrónico Fetal Intraparto (MEFI). Frente a un MEFI sugerente de hipoxemia fetal, existen maniobras estándar de resucitación intrauterina como lateralización de la paciente, aporte de volumen intravenoso y suspensión de la infusión oxitócica. Se debate la utilidad de la hiperoxigenación materna y la tocolisis aguda. Revisamos la evidencia científica relevante sobre la utilidad y seguridad de estas dos maniobras. Encontramos sólo limitada evidencia respecto del efecto benéfico de la hiperoxigenación materna frente a alteraciones del MEFI, existiendo dudas de su inocuidad. La tocolisis aguda ha demostrado ser eficaz en lograr la normalización del MEFI, independiente de la presencia de hiperactividad uterina, con una efectividad cercana al 80%. La evidencia apoya el uso de ß-miméticos y Nitroglicerina. Recomendamos incluir en la práctica clínica habitual la tocolisis aguda y la hiperoxigenación materna sólo por lapsos breves, junto a las maniobras habituales de resucitación intrauterina frente a un MEFI alterado. PALABRAS CLAVE: Monitoreo electrónico fetal intraparto, hipoxia fetal, hiperoxigenación materna, tocolisis intraparto, resucitación intrauterina SUMMARYLabor is a risk condition for acute fetal hypoxia, this hypoxia can be detected by using cardiotocography (CTG). When CTG suggest hypoxia, intrauterine resuscitation techniques must be implemented, such as lateral positioning of the mother, intravenous fluid administration and suspension of oxytocin administration. Among intrauterine resuscitation techniques it is discussed the use of maternal hyperoxygenation and acute tocolysis. Here we review the evidence supporting utility and safety of these two techniques. We found only limited evidence supporting the beneficial role of maternal hyperoxygenation after nonreassuring CTG, plus concerns about its safety. Acute tocolysis has proven to be efficient in normalizing CTG, independent of the presence of uterine hyperactivity, with an overall benefit of 80%. Evidence supports the use of ß-mimetics and nitroglycerin. We recommend to include acute tocolysis and maternal hyperoxygenation (just for limited time), among intrauterine resuscitation techniques for abnormal CTG.

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“…Although hexoprenaline seemed to improve the blood gas values and reduced the uterine activity, the small sample size and absence of a control group does not allow conclusions to be drawn. PATRIARCO et al [7] randomised patients with persistent fetal heart rate changes and fetal scalp blood pH of less than 7.25 to a terbutaline-treated or control group. In the terbutaline group, Apgar scores were more likely to be higher and fewer babies were acidotic.…”

Section: Discussionmentioning

confidence: 99%

Betamimetics in fetal distress: a randomised controlled trial

Kulier

Gülmezoglu²,

Hofmeyr³

et al. 1997

Jpme

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The objective of the study was to investigate if a single dose of Hexoprenaline administered to patients diagnosed as having fetal distress improves neonatal outcome and whether there are any side effects and complications related to hexoprenaline injection. Patients with fetal distress diagnosed by electronic fetal heart rate monitoring with a gestational age of 35 weeks or more in active labor were eligible. Once the decision to deliver the patient by Cesarean section was made, patients were approached and randomised by sealed opaque envelopes to hexoprenaline or control groups. Ten micrograms of hexoprenaline were administered intravenously to study patients. Main outcomes were cord blood gas values, Apgar scores, the need for resuscitation and admission to intensive care. There were no statistically significant differences in the main outcome measures between the two groups. Fewer babies in the hexoprenaline group had a pH of < 7.2 and a base excess of < -10, but this was not statistically significant. The fetal heart rate pattern was improved in significantly more patients after hexoprenaline administration than controls. In conclusion, despite the statistically significant improvement in fetal heart rate tracings, Apgar scores and blood gas values showed only a trend towards improvement in the hexoprenaline group.

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A study on intrauterine fetal resuscitation with terbutaline

Cited by 35 publications

References 6 publications

In vitro myometrial contractility reflects indication for caesarean section

In vitro myometrial contractility reflects indication for caesarean section

Efectividad De La Hiperoxigenación Materna Y Tocolisis Aguda en Monitoreo Electrónico Fetal Intraparto Alterado

Betamimetics in fetal distress: a randomised controlled trial

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