Severe Cardiotocographic Pathology at Labor: Effect of Acute Intravenous Tocolysis

Abstract

The purpose of this study was to evaluate the effect of acute tocolysis on severely pathological cardiotocographic (CTG) readings during the first stage of labor. Seventy-three consecutive parturients with full-term pregnancy were treated by acute tocolysis with a beta-mimetic agent after recognition of severe CTG abnormality in the first stage of labor. The main outcome measures were normalization or persistence of the CTG pattern after tocolysis. Risk factors with regard to CTG effect of tocolysis were also evaluated. In 67% of cases the CTG pattern normalized at a mean of 4 minutes after the beginning of intravenous tocolysis. No characteristic feature of the parturient, labor course, CTG abnormality, or the parameters of uterine contractive activity was found to be a predictive factor with regard to the CTG effect of tocolysis. No adverse effects of tocolytic therapy were found. Tocolysis with a beta-mimetic agent is an effective method to normalize the CTG pattern during the first stage of labor, even in cases without uterine hypertonicity.

Effects of maternal ritodrine hydrochloride administration on the heart rate of preterm fetal sheep with intraamniotic inflammation

“…The 24-h interval between drug injections was based on the half-life of ritodrine hydrochloride; it was also selected to minimize the differences in the phase of intraamniotic inflammation. The MRA doses of 200 and 800 μg/min have been validated for use in short-term tocolysis to treat PTL and for use in acute tocolysis to treat intrauterine fetal distress, respectively [ 5 , 6 , 13 , 38 ]. As short-term MRA is recommended in clinical settings, and the duration of MRA to treat intrauterine fetal distress is clinically up to 2 hours, we comprehensively examined the effect of MRA for 2 h. The concentration of ritodrine hydrochloride in fetal serum was analyzed by liquid chromatography with tandem mass spectrometry (LC-MS/MS) [ 39 ] to confirm that fetal physiological changes were caused by MRA.…”

Optimiert die Fetalblutanalyse die Qualität der geburtshilflichen Versorgung?

“…Dies gilt, obwohl es sich hierbei um ein Verfahren mit hoher Sensitivität handelt, welches nahezu sämtliche Fälle von kindlicher Gefährdung anzeigt, jedoch bei auffälliger kardiotokographischer Befundung in der Mehrzahl der Fälle für das Kind tatsächlich keine direkte Gefahr besteht. Es ist somit eine niedrige Spezifität der auffälligen kardiotokographische Befunde zu konstatieren [2, 4, 6,7,9,17,21,23,26,35,39].…”