Exploring the role of Tractocile in everyday clinical practice

Abstract

The purpose of this retrospective study is to evaluate the effects of atosiban (Tractocile available in Austria since February 2000) for routine treatment of women with threatened preterm delivery. The advantage of this drug compared to other tocolytic agents is its specific action on reproductive tissues without the accompanying severe side effects. Women (n = 208) were retrospectively evaluated. Diagnoses at admission were preterm labour (n = 117), preterm rupture of membranes (n = 65), incompetent cervix (n = 19) and vaginal bleeding (n = 7). Gestational age was between weeks 21 and 33 of pregnancy. Preterm labour was defined as >/=4 uterine contractions/30 min and cervical length <30 mm examined by vaginal ultrasound and/or detection of vaginal fetal fibronectin. Tocolytic effectiveness was determined as the number of women having a diagnosis of preterm labour who were still pregnant after 48 hours and after 7 days. The influence on the frequency of contractions before and 3-12 hours after the start of treatment was assessed. Maternal side effects, perinatal and neonatal morbidity and transfers to the NICU were also evaluated. The proportion of women who remained undelivered was 78.7% after 48 hours, and 64.3% after 7 days. Atosiban decreased the frequency of contractions from 5.4/30 min before treatment to 1.6 contractions/30 min after the start of treatment. At the initial bolus application, 20.2% of women presented drug-related side effects, such as nausea, vertigo and flush over a short period of 1-2 minutes. During infusion, side effects possibly related to atosiban could be detected in 6% of women. Mean length of stay was 11.8 days in the NICU and 30.9 days in intermediate care. Twenty-three children developed intraventricular haemorrhage (I-IV). In conclusion, atosiban is an effective tocolytic drug in the treatment of preterm labour and preterm rupture of the membranes. It has significantly less side effects due to its lack of cardiovascular activity.

Evaluation of Atosiban Therapy in the Management of Preterm Labour in Indian Patients

“…Similar results were reported by previous studies with overall mean number of days gained in utero with atosiban ranged from 31 to 35 days. [15,16,17] Interestingly the number of patients reaching a gestation age > 37 weeks were 57 (27.80%), which shows a very promising activity of the drug for the preservation of maternal and fetal wellbeing.…”

Oxytocin Antagonists for the Management of Preterm Birth: A Review

“…Helmer et al 31 treated 208 women between 21 and 31 weeks of gestation with preterm labor (n ¼ 117), preterm rupture of membranes (n ¼ 65), incompetent cervix (n ¼ 19) or vaginal bleeding (n ¼ 7) with atosiban. Respectively, at 48 hours and 7 days, 78.7% and 64.3% of women were still pregnant.…”

“…Helmer et al 31 noted that 20.2% of women experienced drug-related side effects during the atosiban load, whereas the rate of side effects decreased to 6% during the maintenance infusion. They found a significant decrease in side effects when the bolus administration occurred over 3 minutes rather than 1 minute.…”

Μεταβολές των κυτταροκινών IL-1β, IL-6, TNF-α, καθώς και του εκλυτικού παράγοντα της κορτικοτρόπου ορμόνης (CRH) μετά την χορήγηση ενός ανταγωνιστή της ωκυτοκίνης [1-deamino-2-D-Tyr-8-Orn]-Oxytokin (Atosiban) σε πρόωρο τοκετό

“…Ο ρόλος της ωκυτοκίνης στον τοκετό είναι περίπου γνωστός. Πλήθος μελετών υποδηλώνουν ότι αυτή η ουσία παίζει σημαντικό ρόλο στον πρόωρο τοκετό (188,189). Η ωκυτοκίνη έχει βρεθεί ότι προκαλεί συστολή των λείων μυών, αυξάνοντας την ενδοκυττάρια ροή του ασβεστίου από το σαρκοπλασματικό δίκτυο και μέσω των υποδοχέων των διαύλων ασβεστιου επιτρέποντας τη φωσφορυλίωση της μυοσίνης, και προάγοντας την αλληλεπίδραση ακτίνηςμυοσίνης (190).…”