Effects of ritodrine hydrochloride tocolysis on echocardiographic parameters.
OBJECTIVE
Preterm delivery is a leading cause of perinatal mortality and morbidity. The aim of this study was to determine the effect of ritodrine hydrochloride, used for tocolysis and having serious cardiovascular side effects, on echocardiographic parameters.


METHODS
Sixty-two pregnant women were included in our study. The study and control groups were composed of patients with preterm labor (group A, N = 30) and patients with uneventful pregnancies (group B, N = 32), respectively. While the patients in group A were evaluated before and during treatment, those in group B were evaluated only once for ejection fraction and fractional shortening of the left side of the heart with echocardiography and for the regional systolic and diastolic functions with the tissue Doppler technique. One-way ANOVA and a t-test (paired comparison) were used for statistical purposes.


RESULTS
For the left side of the heart, it was shown that while fractional shortening increased with tocolysis (p < 0.05), neither the ejection fraction nor E/A ratio, showing diastolic function, changed significantly (p < 0.01). While systolic function parameters (S(asep) and S(alat)) increased due to the inotropic and chronotropic actions of the beta-mimetic agents (p < 0.05), regional diastolic function parameters (E(asep)/A(asep) and E(alat)/A(alat)) did not change (p > 0.05).


CONCLUSIONS
Due to its potent inotropic and chronotropic effects, ritodrine hydrochloride increases myocardial oxygen demand significantly. Therefore, it should be used sparingly or avoided altogether in patients with ischemic or structural heart disease.
Tulumbaci
Onder
O
Department of Obstetrics and Gynecology, Yuzuncu Yil Hospital, Ankara, Turkey.
Onan
M Anil
MA
Turkoglu
Sedat
S
Kurdoglu
Mertihan
M
Boyaci
Bulent
B
Tiras
M Bulent
MB
D000328:Adult; D003971:Diastole / Q000187:drug effects; D015150:Echocardiography, Doppler; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D012312:Ritodrine / Q000494:pharmacology*; D013318:Stroke Volume / Q000187:drug effects*; D013599:Systole / Q000187:drug effects*; D015149:Tocolytic Agents / Q000494:pharmacology*
D015149:Tocolytic Agents; D012312:Ritodrine