A study of maternal ECG characteristics before and during intravenous tocolysis with beta-sympathicomimetics. Effects of i.v. tocolysis on maternal ECG characteristics.
Severe maternal complications during beta-mimetic therapy have been reported. In a study of maternal complications related to intravenous tocolysis, which covering a period of 2 years, we paid special attention to the maternal ECG before and during treatment. There was a high prevalence of pretreatment ECG changes: tachycardia (23.6%), disorders of impulse conduction (43.6%), ST-depression (14.5%) and disorders of repolarization (43.6%). During intravenous beta-mimetic therapy there was an increase in the prevalence of tachycardia, prolonged QT-time and disorders of repolarization. We also studied the course in time of the different ECG characteristics during treatment. With regard to the ST-depression, a possible physiological adaptation to the beta-mimetic drug is described. We could not find this possible adaptation with regard to the other ECG characteristics. None of the women in the studied group showed clinical signs of myocardial ischemia, notwithstanding the high prevalence of ECG changes. We conclude that the ECG criteria for discontinuation of tocolytic therapy need re-evaluation.
Mulders
L G
LG
Department of Obstetrics and Gynecology, St. Radboud Hospital, University of Nijmegen, The Netherlands.
Boers
G H
GH
Prickartz-Wijdeveld
M M
MM
Hein
P R
PR
D000328:Adult; D001145:Arrhythmias, Cardiac / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D005280:Fenoterol / Q000009:adverse effects*; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis / Q000209:etiology*; D011446:Prospective Studies; D012312:Ritodrine / Q000009:adverse effects*
D005280:Fenoterol; D012312:Ritodrine