Comparison between atosiban and nicardipine in inducing hypotension during in-utero transfers for threatening premature delivery.
BACKGROUND
The aim of this study was to compare the frequency of hypotension induced by oxytocin antagonist atosiban and nicardipine.


METHODS
This case-control study enrolled 14 pregnant women presenting with threatening premature delivery treated with atosiban and managed by a physician-staffed Emergency Medical Service Department (French Emergency Medical Service system) during inter-hospital transfers. A control group of 42 consecutive pregnant women presenting with threatening premature delivery managed during inter-hospital transfers during the same period and treated with nicardipine was set up. The control group was recruited after matching on confounding variables: age 38 years or less and no previous cardiovascular disease to avoid factors related to the occurrence of cardiovascular events, duration of out-of-hospital management of at least 60 min to have similar likelihood of side-effect occurrence, and parity 2 or less and gestational age from 25 to 32 weeks to make comparable groups from the obstetrical viewpoint. Frequency of hypotension was compared between the two groups.


RESULTS
Hypotension was observed in two patients (8%) in the atosiban-group and in five patients (14%) in the nicardipine-group, which is not significantly different (P>0.99).


CONCLUSIONS
Despite the notion that oxytocin antagonist atosiban has limited or no systemic adverse effects, these results suggest that this cost-consuming drug does not avoid hypotension and cannot help to reduce the level of monitoring.
Duchateau
François-Xavier
FX
Department of Anaesthesiology and Intensive Care, Beaujon University Hospital, Clichy, France. fxduchateau@orange.fr
Max
Adeline
A
Harscoat
Sébastien
S
Curac
Sonja
S
Ricard-Hibon
Agnès
A
Mantz
Jean
J
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007023:Hypotension, Controlled / Q000379:methods*; D007231:Infant, Newborn; D007234:Infant, Premature; D009529:Nicardipine / Q000627:therapeutic use*; D010121:Oxytocin / Q000037:antagonists & inhibitors; D010360:Patient Transfer; D011247:Pregnancy; D012306:Risk; D012307:Risk Factors; D015149:Tocolytic Agents / Q000627:therapeutic use*; D014668:Vasotocin / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000959:Antihypertensive Agents; D015149:Tocolytic Agents; C047046:atosiban; D010121:Oxytocin; D009529:Nicardipine; D014668:Vasotocin