title: Successful treatment with granulocyte-colony stimulating factor for ritodrine-induced neutropenia in a twin pregnancy.
abstract: OBJECTIVE
  Neutropenia developed after continuous intravenous infusion of ritodrine hydrochloride (Yutopar) for preterm uterine contractions in a twin pregnancy. We successfully returned the low neutrophil count to the normal range after discontinuation of infusion of ritodrine and treatment with granulocyte colony stimulating factor (G-CSF).
  
  
  METHODS
  A 34-year-old woman with twin pregnancy was treated with ritodrine for preterm uterine contractions at 27 weeks and 6 days gestation. Neutropenia developed after continuous intravenous infusion of ritodrine for about 4 weeks. We ceased the ritodrine infusion immediately and treated the neutropenia with G-CSF. A cesarean delivery was performed the day after cessation of the ritodrine infusion because of uncontrolled preterm labor. There were no adverse side effects or infectious complications in the mother or the newborns. The maternal neutrophil count recovered to the normal range 4 days after administration of G-CSF.
  
  
  CONCLUSIONS
  Based on prior case reports and the clinical presentation of our case, G-CSF may be a useful treatment for pregnant women with ritodrine-induced neutropenia. However, more clinical studies are required to confirm the safety and efficacy of this treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chen-Yu
authors.initials: CY
authors.lastname: Wang
authors.affiliation: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Yu-Ju
authors.initials: YJ
authors.lastname: Lai
authors.affiliation: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Kwei-Shuai
authors.initials: KS
authors.lastname: Hwang
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Center for Reproductive Medicine, Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan.
authors.forename: Chi-Huang
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Mu-Hsien
authors.initials: MH
authors.lastname: Yu
authors.affiliation: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Huei-Tsung
authors.initials: HT
authors.lastname: Chen
authors.affiliation: Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. Electronic address: su108868@gmail.com.
authors.forename: Her-Young
authors.initials: HY
authors.lastname: Su
mesh_terms: D000328:Adult; D002585:Cesarean Section; D003115:Colony-Stimulating Factors / Q000494:pharmacology*; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D009503:Neutropenia / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*; D011247:Pregnancy; D059285:Pregnancy, Twin; D012312:Ritodrine / Q000009:adverse effects*; D015149:Tocolytic Agents / Q000009:adverse effects
chemical_list: D003115:Colony-Stimulating Factors; D015149:Tocolytic Agents; D012312:Ritodrine
keywords: neutropenia; preterm labor; preterm uterine contractions; ritodrine; tocolysis