title: 48-hours administration of fenoterol in spontaneous preterm labor - Doppler blood flow assessment of placental and fetal circulation.
abstract: OBJECTIVE
  The aims were to investigate whether any changes in placental and fetal circulation were observed during fenoterol tocolysis within the first 48 hours of therapy.
  
  
  METHODS
  Doppler evaluation of placental and fetal circulation was performed prior to fenoterol administration and then after 24 and 48 hours. Maternal heart rate and pulsatility index (PI) in uterine arteries were assessed. FHR, RI and PI of umbilical artery and middle cerebral artery were measured. E/A ratio for A-V valves, the myocardial performance index (MPI) and shortening fraction (SF) were calculated for both ventricles independently. The blood flow pattern in DV was assessed using PI, S/a ratio and peak velocity index for the vein. To determine changes over time in all study variable analysis of variance (ANOVA) for repeated measurements followed by Tukey-Kramer's multiple comparison test was used. The effects of additional clinical covariates were checked.
  
  
  RESULTS
  Uterine and fetal arterial blood flow patterns were not altered significantly during 48 hours of tocolysis. No significant changes were observed in fetal cardiac function parameters as well. The evaluation of Doppler parameters in the DV revealed a significant increase in PVIV after 48 hours. Additionally after 48 hours of successful tocolysis S/a ratio values were significantly lower.
  
  
  CONCLUSIONS
  Short term intravenous administration of fenoterol seems not to alter uterine and fetal arterial blood flow pattern. Direct fetal cardiac function remained unaffected. However significant changes of selected Doppler parameters in DV may suggest further studies should be performed to assess more precisely fetal venous blood flow.
authors.affiliation: Department of Feto-Maternal Medicine and Gynecology, "Polish Mother" Memorial Research Institute, Lodz, Poland. mariusz.grzesiak@gmail.com.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Grzesiak
authors.affiliation: Department of Feto-Maternal Medicine and Gynecology, "Polish Mother" Memorial Research Institute, Lodz, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Hincz
authors.affiliation: Department of Radiology, "Polish Mother" Memorial Research Institute, Lodz, Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Forys
authors.affiliation: Division of English Studies, The Medical University of Lodz, Poland.
authors.forename: Rehana B
authors.initials: RB
authors.lastname: Ahmed
authors.affiliation: Department of Feto-Maternal Medicine and Gynecology, "Polish Mother" Memorial Research Institute, Lodz, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Wilczynski
mesh_terms: D000328:Adult; D005260:Female; D005280:Fenoterol / Q000008:administration & dosage*; D005333:Fetus / Q000098:blood supply* / Q000187:drug effects; D006339:Heart Rate / Q000187:drug effects; D006340:Heart Rate, Fetal / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D007752:Obstetric Labor, Premature / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010920:Placenta / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000187:drug effects; D011247:Pregnancy; D015149:Tocolytic Agents / Q000008:administration & dosage*; D016216:Ultrasonography, Prenatal; D055815:Young Adult
chemical_list: D015149:Tocolytic Agents; D005280:Fenoterol