title: [Atosiban as a tocolytic agent: a new proposal of a therapeutic approach].
abstract: OBJECTIVE
  to test a therapeutic approach using atosiban for tocolysis, evaluating its safety and maternal and fetal side effects.
  
  
  METHODS
  prospective study with 80 pregnant women with preterm labor admitted for tocolysis.
  
  
  METHODS
  singleton pregnancy, regular uterine activity, cervical dilatation between 1 to 3 cm, cervical enfacement greater than 50%, 23 to 33 weeks and six days of gestational age, intact membranes, amniotic fluid index between 5 and 25, no maternal, fetal or placental diseases, no fetal growth restriction, no cervical incompetence, no fever.
  
  
  METHODS
  chorioamnionitis or fever during tocolysis. Atosiban group: women received 6.75 mg atosiban iv in bolus, 300 mcg/min for three hours, then 100 mcg/min for three hours and thirty minutes. If uterine activity persisted, it was maintained iv infusion of 100 mcg/min for 12.5 hand that so for as long as 45 hours.
  
  
  METHODS
  women received terbutaline (five ampoules, 500 mL crystalloid solution) iv infusion, 20 mL/h. If uterine activity persisted, infusion velocity was raised (20 mL/h) until uterine contractions were absent. The dose was maintained for 24 hours.
  
  
  RESULTS
  gestational age at birth was 29 weeks and five days to 40 weeks and six days. In atosiban group, the proportion of women who had not delivered at 48 hours was 97.5%, mean interval between tocolysis and birth of 28.2 days. In control group, birth occurred before 48 hours in 22.5% of the cases; mean interval between tocolysis and birth of 5.3 days. Maternal side effects were observed in 27.5% of cases of the atosiban group, none with tachycardia, dyspnea or tachypnea. In the control group, 75% of the cases referred palpitations, tachycardia, tachypnea or headache (drug infusion was interrupted in four cases). Fetal tachycardia was observed in 22.5% of the cases (n=9). No early neonatal death was observed.
  
  
  CONCLUSIONS
  the therapeutic approach used showed to be effective for tocolysis, with low incidence of maternal, fetal and neonatal side effects.
authors.affiliation: Departamento de Obstetrícia e Ginecologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. fabiocabar@uol.com.br
authors.forename: Fábio Roberto
authors.initials: FR
authors.lastname: Cabar
authors.forename: Roberto Eduardo
authors.initials: RE
authors.lastname: Bittar
authors.forename: Cláudia Messias
authors.initials: CM
authors.lastname: Gomes
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011446:Prospective Studies; D015149:Tocolytic Agents / Q000627:therapeutic use*; D014668:Vasotocin / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D015149:Tocolytic Agents; C047046:atosiban; D014668:Vasotocin