DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20205228

Assessment of the efficacy of glyceryl trinitrate patch as a tocolytic

Sushma Mogri, Lata Choudhary, Anjana Verma

Abstract


Background: Preterm labor is defined as onset of delivery after the age of gestational viability (20-28 weeks) and prior to 37 weeks. Preterm birth complicated 5-10% of all births and accounts for 75% of perinatal deaths. Several drugs are now available to delay delivery in spontaneous preterm labour. Delaying the delivery for at least 24-48 hr for lung maturity of fetus is the primary goal. Glyceryl trinitrate has less maternal side effects.

Methods: The study included 100 women who were admitted in view of preterm labour with gestational age between 28-36 weeks and were given trans dermal nitroglycerin therapy for arrest of preterm labour.

Results: The efficacy of nitroglycerine patch to arrest preterm labour was studied. 88 patients were successfully progressed for more than 48 hours with minimum prolongation of 3 days and maximum prolongation of 65 days and average prolongation of 26 days of pregnancy.

Conclusions: Glyceryl trinitrate patch as a tocolytic is very effective. This drug has a good patient acceptability and compliance due to its minimal side effects, low cost and simple dosage schedule.


Keywords


Glyceryl trinitrate, Preterm labor, Tocolytics.

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References


Cunningham F, Leveno K, Bloom S, Hauth J, Rouse D, Spong C. Preterm birth. Williams Obstetrics. 23rd ed. New York: McGraw Hill 2009;804-32.

Edwin chandraharan, Recent advances in management of preterm labor. J Obst Gyn Ind. 2005;55:118-24.

Rush RW, Keirse MJ, Howat P, Baum JD, Anderson AB, Turnbull AC. Contribution of preterm delivery to perinatal mortality. Brit Med J. 1976;2(6042):965-8.

American College of Obstetricians and Gynecologists. Management of preterm labor: Practice Bulletin no. 171. Obstet Gynecol. 2016;128(4):e155-64.

Katzung B. Basic & clinical pharmacology: Lange Medical Books. 11th ed. London: McGraw Hill 2001;93-6.

Lamont RF. Advances in the prevention of infection related preterm birth. Front Immunol. 2015;6:566.

Leszczynska-Gorzelak B, Laskowska M, Marciniak B, Oleszczuk J. Nitric oxide for treatment of threatened preterm labor. Int J Gynaecol Obstet. 2001;73(3):201-6.

Mirteimoori M, Sakhavar N, Teimoori B. Glyceryl trinitrate versus magnesium sulphate in the suppression of preterm labour. Shiraz E Med J. 2009;10:73-8.

Smith GN, Guo Y, Wen SW, Walker MC. Secondary analysis of the use of transdermal nitroglycerin for preterm labor. Am J Obstet Gynecol. 2010;203:565-6.

Schleussner E, Moller A, Gross W, Kahler C, Moller U, Richter S, et al. Maternal and fetal side effects of tocolysis using transdermal nitroglycerin or intravenous fenoterol combine with magnesium sulfate. Eur J Obstet Gynecol Reprod Biol. 2003; 105:14-9.

Schleussner E, Richter S, Gross W, Kahler C, Moller A, Moller U, et al. Nitroglycerin patch for tocolysis- a prospective randomized comparison with fenoterol by infusion. Z Geburshife Neonatal 2001;205:189-94.

Rowland S, Tridinger B, Visvatingam S, Aust NZ. Treatment of Preterm Cervical Dilatation With Glyceryl Trinitrate, a Nitric Oxide Doner. J Obstet Gynaecol. 1996;36:377.

Lees C, Campbell S, Jauniaux E, Brown R, Ramsay B, Gibb D, et al. Arrest of preterm labour and prolongation of gestation with glyceryl trinitrate, a nitric oxide donor. Lancet. 1994;343(8909):1325-6.

Shah K, Gupta BD. Dermal Nitroglycerin Patch in Treatment of Preterm Labor. J Biosci Medic. 2015;3:82-90.

Walling AD. Compairing glyceryl trinitrate and ritodrine in tocolysis. Americ Fam Physic. 2000.

Kumar A, Bharadwaj B, Pawar N. Glyceryl trinitrate Patch in management of preterm labour. J Obstet Gynaecol. 2001;51:55-7.

Parveen S, Ainuddin JA, Naz S. Short term tocolytic efficacy of transdermal nitroglycerine. Medic Chann. 2010;16:75-7.