Comparison of Doppler blood flow indices in fetal & uterine arteries before and after tocolysis for preterm labor

Objective

Preterm labor is the most important cause of neonatal morbidity and mortality in developed countries. The aim of this study was to compare and evaluate the effects,nifedipine and ritodrine, on fetal and maternal parameters and to predict the patient with therapotic succes.

Methods

The study was carried out on 64 patients with diagnosis of preterm delivery, admitted to our unite.The cases were randomly selected singleton pregnancies between 24-36 weeks of gestation who were in the latent phase of labor and despite 2 hours of bed rest, 2 or more uterine contractions in 10 minutes were detected with either manual examination or tococardiographic evaluation. Patients with preterm delivery accompanying fetal distress, ablation plasenta, chorioamnionitis, preeclampsia and fetal anomalies were excluded from our study. A total of 64 patients were randomly divided into two groups according to administiration of either ritodrine or nifedipine. Clinical and laboratory parameters, cervical length and early and late doppler measurements of umbilical artery, bilateral uterine arteries,ductus venosus and middle cerebral artery were recorded.

Results 

When we evaluated the results of the study there were statistically no difference between two groups doppler values for umbilical artery, middle cerebral artery and ductus venosus. Also there were no statistically difference betwen two groups in terms of prolongation of pregnancy. Only significant difference evaluated in uteroplacental blood flow. In Nifedipine group bilateral uterine arteries PI was significantly decrased after medication.Also there was no difference on Doppler values between patients with and without therapotic success.

Conclusion 

Since efficiency and vascular side effects of both drugs were recorded to be similar, the choice of tocolytic agent in preterm labor should be made according to the side effect profile, cost, applicability in clinical settings and patient coherence to treatment.

Keywords

Doppler ultrasonography, nifedipine, ritodrine

	File/Dsecription
	Table 1 Maternal Characteristics of Tocolysis Groups