Maternal and fetal side effects of tocolysis using transdermal nitroglycerin or intravenous fenoterol combined with magnesium sulfate.
OBJECTIVE
To compare the maternal and fetal side effects of transdermal nitroglycerin and intravenous fenoterol combined with magnesium sulfate in a prospective randomised study.


METHODS
Fifty pregnant women between 27 and 35 weeks of gestation with preterm labour were treated with either nitroglycerin (0.4-0.8 mg/h) or fenoterol (60 - 120 microg/h). Outcome parameters were (1) the effects on fetal and maternal heart frequency (FHF/MHF) and blood pressure, and (2) subjective experiences of adverse effects assessed by utilising a questionnaire.


RESULTS
In the fenoterol group, elevated mean MHF, FHF and systolic blood pressure were recorded compared to nitroglycerin. Fewer maternal side effects were reported in the nitroglycerin group. Palpitations (82%), tremor (68%) and restlessness (64%) were most common in the fenoterol group (two drop-outs), whereas nitroglycerin caused headaches in 71% of the cases (four drop-outs).


CONCLUSIONS
Transdermal nitroglycerin appears to be a safe therapy for the mother and fetus and is a promising new option for the treatment of preterm labour.
Schleussner
Ekkehard
E
Department of Obstetrics and Gynaecology, Friedrich Schiller University Jena, Bachstrasse18, 07740, Jena, Germany. ekkehard.scheussner@med.uni-jena.de
Möller
Arne
A
Gross
Walter
W
Kähler
Christiane
C
Möller
Udo
U
Richter
Sabine
S
Seewald
Hans Joachim
HJ
D000279:Administration, Cutaneous; D000293:Adolescent; D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D005280:Fenoterol / Q000008:administration & dosage / Q000009:adverse effects*; D005333:Fetus / Q000187:drug effects*; D005858:Germany; D006261:Headache / Q000139:chemically induced; D006339:Heart Rate / Q000187:drug effects*; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D008278:Magnesium Sulfate / Q000008:administration & dosage / Q000009:adverse effects; D005996:Nitroglycerin / Q000008:administration & dosage / Q000009:adverse effects*; D007752:Obstetric Labor, Premature / Q000188:drug therapy; D011247:Pregnancy; D011446:Prospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D015145:Tocolysis / Q000009:adverse effects* / Q000379:methods / Q000523:psychology; D015149:Tocolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D014202:Tremor / Q000139:chemically induced
D015149:Tocolytic Agents; D005280:Fenoterol; D008278:Magnesium Sulfate; D005996:Nitroglycerin