[Effectiveness and safety of atosiban vs. pulsatile administration of fenoterol in the treatment of preterm labour].

Abstract

BACKGROUND:

The aim of this study was to compare the efficacy and side effects of atosiban with those of fenoterol (pulsatile administration) for acute tocolysis.

METHODS:

A prospective, open-label, randomised controlled trial was performed. Patients in preterm labour at 24+0 to 33+6 weeks of gestation were randomised to receive atosiban (A) or fenoterol (F) pulsatile administration. Primary outcome was the arrest of preterm labour.

RESULTS:

The proportion of woman remaining undelivered at 48 hours (86.3% atosiban group and 79.6% fenoterol group) and at 7 days (78.4% vs. 66.7%) was comparable. The incidence of maternal cardiovascular side effects was lower in the atosiban group (4% vs. 78%, p=0.0). Tocolysis was terminated as a result of maternal adverse effects in the fenoterol group (9%). Fetal tachycardia was lower in the atosiban group (2% vs. 22%). The mean duration of tocolytic administration was lower in the atosiban group (19 h vs. 24.5 h, p<0.05).

DISCUSSION:

The adverse effects in the pulsatile administration of fenoterol for short duration were only dependent on the initial dosage for the arrest of preterm labour. Neonatal outcome were similar between the treatment groups and were rather related to the gestational age not to the tocolytic agent.

CONCLUSIONS:

Atosiban was comparable in clinical effectiveness and was associated with fewer maternal and fetal adverse effects, so that fenoterol cannot be recommended. Completion of tocolytic therapy 12 hours after arrest of preterm labour is effective and associated with a short mean duration.

• Authors: A Nonnenmacher, H Hopp, J Dudenhausen
• Journal: Zeitschrift fur Geburtshilfe und Neonatologie (Z Geburtshilfe Neonatol) Vol. 213 Issue 5 Pg. 201-6 (Oct 2009) ISSN: 1439-1651 [Electronic] Germany
• Vernacular Title: Wirksamkeit und Sicherheit von Atosiban vs. pulsatiler Applikation von Fenoterol bei der Behandlung vorzeitiger Wehen.
• PMID: 19856243 (Publication Type: English Abstract, Journal Article, Randomized Controlled Trial)
• Copyright: Georg Thieme Verlag KG Stuttgart-New York.

Chemical References

• Hormone Antagonists
• Tocolytic Agents
• atosiban
• Fenoterol
• Vasotocin

Topics

• Adolescent
• Adult
• Female
• Fenoterol (administration & dosage, adverse effects)
• Hormone Antagonists (administration & dosage, adverse effects)
• Humans
• Obstetric Labor, Premature (prevention & control)
• Pregnancy
• Tocolytic Agents (administration & dosage, adverse effects)
• Treatment Outcome
• Vasotocin (administration & dosage, analogs & derivatives)
• Young Adult