Severe hyperinsulinaemic hypoglycaemia in a baby born to a mother taking oral ritodrine therapy for preterm labour.
Hyperinsulinism of infancy is a major cause of persistent hypoglycaemia in the newborn period. Transient mild self-limiting hyperinsulinaemia and hypoglycaemia have been described in neonates born to mothers taking ritodrine therapy for premature labour. Ritodrine crosses the placental barrier and enters the fetal circulation readily but the mechanism of how it causes hyperinsulinaemia and hypoglycaemia is unclear. We report the case of severe prolonged hyperinsulinaemic hypoglycamia in a neonate born to a mother taking ritodrine therapy from 16 weeks' gestation for preterm labour. The hyperinsulinaemic hypoglycaemia was managed with oral nifedipine as diazoxide was contraindicated due to fluid overload. Possible mechanisms of ritodrine-induced hypoglycaemia and insulin secretion are discussed.
Kurtoglu
Selim
S
Medical Faculty, Erciyes University, Kayseri, Turkey. selimk@erciyes.edu.tr
Akcakus
Mustafa
M
Keskin
Mehmet
M
Ozcan
Ahmet
A
Hussain
Khalid
K
D000328:Adult; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000139:chemically induced*; D007003:Hypoglycemia / Q000139:chemically induced*; D007231:Infant, Newborn; D007328:Insulin / Q000097:blood; D009543:Nifedipine / Q000627:therapeutic use; D007752:Obstetric Labor, Premature / Q000150:complications / Q000188:drug therapy; D011247:Pregnancy; D012312:Ritodrine / Q000009:adverse effects* / Q000627:therapeutic use; D015149:Tocolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use
D002121:Calcium Channel Blockers; D007328:Insulin; D015149:Tocolytic Agents; D012312:Ritodrine; D009543:Nifedipine