title: Severe hyperinsulinaemic hypoglycaemia in a baby born to a mother taking oral ritodrine therapy for preterm labour.
abstract: 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.
authors.affiliation: Medical Faculty, Erciyes University, Kayseri, Turkey. selimk@erciyes.edu.tr
authors.forename: Selim
authors.initials: S
authors.lastname: Kurtoglu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akcakus
authors.forename: Mehmet
authors.initials: M
authors.lastname: Keskin
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozcan
authors.forename: Khalid
authors.initials: K
authors.lastname: Hussain
mesh_terms: 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
chemical_list: D002121:Calcium Channel Blockers; D007328:Insulin; D015149:Tocolytic Agents; D012312:Ritodrine; D009543:Nifedipine