Antenatal corticosteroid administration between 24 hours and 7 days before extremely preterm delivery is associated with the lowest rate of mortality

Travers, Colm P.; Carlo, Waldemar A.

doi:10.1136/ebmed-2017-110742

Cited by 1 publication

(1 citation statement)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, when the frequency of tocolysis in 12 hours and in 48 hours was analyzed, as well as the frequency of premature delivery in the first 48 hours, there was no difference between sublingual and oral nifedipine, suggesting that when therapeutic plasma levels are reached the drug is effective in inhibiting premature delivery regardless of the route of administration . This interval of 48 hours is particularly important because it permits corticosteroid administration to accelerate fetal lung maturation, which appears to be one of the principal functions of tocolytic therapy given the numerous beneficial effects resulting from its administration …”

Section: Discussionmentioning

confidence: 99%

Effectiveness of an oral versus sublingual loading dose of nifedipine for tocolysis

Leal-Júnior

Amorim

Souza

et al. 2019

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Objective:To determine the effectiveness of an oral versus sublingual loading dose of nifedipine for tocolysis.Methods: An open, randomized clinical trial conducted between March 1, 2013, and April 31, 2014. Participants were pregnant women with a diagnosis of premature labor, single live fetus, topical pregnancy, gestational age 24-36 weeks, normal fetal vitality, cervical dilatation less than or equal to 4 cm, cervical effacement less than or equal to 80%, and intact amniotic membranes. They were randomized into two groups, oral and sublingual nifedipine, 20 mg loading dose, repeated every 30 minutes (maximum dose of 60 mg). The primary endpoint was the time until tocolysis and the secondary endpoints were the effectiveness of tocolysis within 90 minutes, 12 hours, and 48 hours; premature delivery within 48 hours; and maternal hemodynamic parameters and side effects. Results: There were 80 patients randomized to oral (n=40) and sublingual (n=40) nifedipine. The time required for tocolysis was significantly less with sublingual nifedipine (160 minutes vs 340 minutes; P=0.0003). Sublingual nifedipine was also more successful than oral nifedipine at inhibiting premature labor within 90 minutes (n=8 [20.0%] vs n=1 [2.5%], P=0.014). There was no statistically significant difference between the groups for the other secondary endpoints. Conclusion: Compared with oral administration, a sublingual loading dose of nifedipine resulted in faster tocolysis in patients with premature labor. Brazilian Clinical Trials Registry (ReBEC): U1111-11566186.

show abstract

Section: Discussionmentioning

confidence: 99%