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• W2885876425 abstract "INTRODUCTION:Obstetrics is a fine art built on the facts gathered by scientificresearch. In the era of modern Obstetrics where there has been a rapidadvancement in all specialities, preterm labour remains an enigma for theobstetricians of today.The social and emotional cost of perinatal mortality and morbidityassociated with preterm birth is immeasurable. Ideally preterm labourshould be prevented. However pharmacological inhibition of pretermlabor remains an effective method to delay preterm delivery and improveneonatal outcome until a most effective means of prevention is identified.Since the Tocolysis has both potential benefits and side effects to neonateand mother, their use should be based on well designed controlled clinicalstudies.AIM OF THE STUDY:Aim of care around preterm birth does not always involveprevention of preterm labour and birth. In situation where clinicalcondition makes it desirable to prolong pregnancy, primary out comeconsidered is time saved to* Seek advice from a perinatal care unit* Institute therapy to improve fetal lung maturity* If necessary move mother to centre with neonatal intensive care unit. Preterm fetus need glucocorticoids to enhance lung maturity. This can be achieved if delivery is postponed by 24 - 48 hours. Inhibition of uterine contraction at least for 2 days may therefore be regarded as optimal acute tocolysis. A great number of drugs are used to inhibitpreterm labour. Aim of our study is to * Evaluate the effect and safety of transdermal nitroglycerine in acute tocolysis.* Effect of transdermal nitroglycerine on maternal and neonatal outcome.MATERIALS AND METHODS:STUDY DESIGN:It is a prospective randomized controlled trial. The study was conducted in Annal Gandhi Memorial Hospital, Trichy from August 2008 to July 2009. 100 patients with preterm labour randomly selected frompatients attending antenatal OPD and from labour ward. 50 patientsrecruited for nitroglycerine patch and another 50 patients for bed restalone. Both the groups received intramuscular corticosteroids. In view ofthe ethical issue, written informed consent was obtained.INCLUSION CRITERIA:1. Gestational age between 28 to 34 wks as determined by menstrual dates, clinical examination, USG.2. Uterine contractions: 2 contractions in 10 minute period, each contraction lasting for 40 sec.3. Progressive cervical effacement upto 75%.4. Cervical dilatation upto 3 cm.5. Intact membranes.EXCLUSION CRITERIA:Maternal Factors:1. Rupture of Membrane,2. Infection,3. Cervical dilatation greater than 3 cm,4. Antepartum hemorrhage,5. Pregnancy induced hypertension,6. Chronic hypertension,7. Cardiac disease,8. Previous caesarean section,9. Renal disease,10. Pulmonary disorder – Asthmatics, ARDS.Fetal Factors:1. Multiple gestation,2. Fetal death / distress,3. IUGR,4. Congenital anomalies,5. Polyhydramnios / Oligohydramnios,6. Erythroblastosis.RESULTS:Study was designed with total sample of randomly selected 100cases who were in Preterm labour, out of which 50 females wererandomly allotted for Nitroglycerine patch in group A and another 50patients in group B observed with bed rest alone. All patients on studywere given corticosteroids. Prophylactic antibiotics also were given to allpatients.CONCLUSION:Labour inhibiting drugs may not treat the cause of preterm labourbut they only treat the symptoms i.e. uterine contractions.As these agents make the uterus refractory to stimuli for a shorttime the perinatal outcome is improved. In this clinical trial, theidiopathic spontaneous preterm labour whose onset was at 30 to 34 weeksof gestation had responded well to tocolytic therapy and neonataloutcome improved and no maternal mortality was observed. Thematernal side effects were reversed on discontinuation of the drug. Thedrug had provided the fetus a valuable opportunity of being inside themother’s womb for a period enough to make the lungs mature byadministration of exogenous steroids.However decrease in the incidence of preterm labour lies in theidentification of high risk patients, improving the socio-economicstandard, better antenatal care, education and early detection of the onsetof preterm labour.On evaluation of transdermal nitroglycerine on acute tocolysis, it isfound that nitroglycerine patch is absolutely safe and successful inachieving complete tocolysis.62Nitroglycerine is not only safe but also has a very minimal sideeffects like headache on mother. It has no untoward side effect onneonate. Neonatal outcome is good in all respects like apgar score, birthweight, less neonatal admission in nitroglycerine therapy.To conclude transdermal nitroglycerine has a very good role toplay as an acute tocolytic in the treatment of preterm labour and shouldbe considered as first line drug of choice." @default.
• W2885876425 created "2018-08-22" @default.
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• W2885876425 date "2010-03-01" @default.
• W2885876425 modified "2023-09-27" @default.
• W2885876425 title "Evaluation of efficacy of transdermal Nitroglycerine in the treatment of preterm labour" @default.
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