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Selected Publication:
Tatschl, V.
Outcome für Mütter und Kinder nach Dauertokolyse mit Atosiban bzw. Gynipral
[ Diplomarbeit/Master Thesis ] Graz Medical University ; 2009. pp. 65
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- Authors Med Uni Graz:
- Advisor:
- Ballon Martina Gabriele
- Lang Uwe
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- Abstract:
- Preterm labor is one of the major problems in modern obstetrics. The preterm birth rate could not be reduced in the last ten years and is almost the same all over the world, only in a few countries increased rates have been registered. Currently the preterm birth rate ranges from 5-10% of all pregnancies. The main clinical symp-toms are premature uterine contractions which have been treated with tocolytic substances like -mimetics, magnesium or oxytocin-antagonists for the last 30 years. Primary goal of the tocolytical therapy is the prolongation of pregnancy for at least 48 hours in order to a) carry out the induction of fetal lung maturation and b) carry out the in-utero transfer to a Clinical Center for Perinatal Medicine. Long term tocolysis exceeding 48 hours is not an official indication however, depending on the individual decision of the treating physician. Especially in cases of recurrent episodes of preterm labor, this therapy should be considered. In the following descriptive analysis I examined the outcome for children and mothers after a long term tocolysis treatment (duration = 72 hours) with Atosiban (A), Hexoprenalin (H)-Monotherapy (MT) or Combinationtherapy (KT) of both. In this descriptive analysis the adverse reactions and events of mothers and children after/during the therapy and during/after birth and puerperium have been worked out. The results of the mothers do not show any massive events/adverse reactions. Overall, the adverse reaction rate was the highest with KT. Cardiovascular events were dominant during treatments with Hexoprenalin (in KT and MT) while Atosi-ban-whether in form of KT or MT- caused only isolated nausea/vomiting, diarrhea, anxiety/agitation and hypotonus. These results fully correspond with findings and statements of the current literature. It is noteworthy that no single case of a pul-monary edema was described with H and that only one single local skin reaction at the injection site was documented with A. Furthermore no accumulation of adverse events could be observed during puerperium. As far as the children are con-cerned, no CTG changes were recorded in utero with KT. Only one case with HMT showed a fetal tachycardia. Unlike with AMT (40 %) and HMT (66 %), the postpar-tal outcome of the children with KT was the worst with 77 % of children showing complications.