Meloxicam effectively inhibits preterm labor uterine contractions in a chronically catheterized pregnant sheep model: impact on fetal blood flow and fetal-maternal physiologic parameters.
OBJECTIVE
Preterm birth occurs in 5% to 10% of all pregnancies and is associated with considerable neonatal mortality and morbidity. Effective and safe drugs to prevent preterm labor are not currently available. We have hypothesized that the nonsteroidal anti-inflammatory drug meloxicam, a more selective cyclooxygenase-2 inhibitor will successfully inhibit labor but avoid the complications associated with inhibition of cyclooxygenase-1.


METHODS
Preterm labor was induced in chronically catheterized sheep by RU486 administration. Animals were then randomized to receive maternal infusions of saline (n = 5) or meloxicam (n = 4) for 48 hours or until delivery when the animals were killed and tissues and blood samples collected.


RESULTS
Maternal infusion of meloxicam inhibited uterine contractions, increasing contraction duration, and attenuating frequency and amplitude. Saline-treated animals progressed to delivery. Administration of meloxicam was not associated with any change in fetal or maternal blood gas status, osmolality, arterial pressure, heart rate, or fetal blood flows.


CONCLUSIONS
Meloxicam may represent a potentially safe and effective tocolytic agent.
Rac
Valeria E
VE
Research Centre for Women's and Infant's Health, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada.
Small
Charlene
C
Scott
Catherine A
CA
Adamson
S Lee
SL
Rurak
Dan
D
Challis
John R
JR
Lye
Stephen J
SJ
D000021:Abortifacient Agents, Steroidal / Q000494:pharmacology; D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000494:pharmacology*; D004576:Electromyography; D005260:Female; D005333:Fetus / Q000187:drug effects / Q000502:physiology; D007422:Intestines / Q000098:blood supply / Q000196:embryology; D007668:Kidney / Q000098:blood supply / Q000196:embryology / Q000502:physiology; D007751:Labor, Induced; D000077239:Meloxicam; D015735:Mifepristone / Q000494:pharmacology; D023421:Models, Animal; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D009994:Osmolar Concentration; D011247:Pregnancy; D011897:Random Allocation; D012039:Regional Blood Flow / Q000187:drug effects; D012756:Sheep; D013843:Thiazines / Q000494:pharmacology*; D013844:Thiazoles / Q000494:pharmacology*; D015149:Tocolytic Agents / Q000494:pharmacology*; D014556:Urine; D014590:Uterine Contraction / Q000187:drug effects*
D000021:Abortifacient Agents, Steroidal; D000894:Anti-Inflammatory Agents, Non-Steroidal; D013843:Thiazines; D013844:Thiazoles; D015149:Tocolytic Agents; D015735:Mifepristone; D000077239:Meloxicam