Effect of Maintenance Therapy with Isoxsuprine in the Prevention of Preterm Labor
Randomized controlled trial
Keywords:
pre-term birth, tocolytic, isoxsuprineAbstract
Background: Isoxsuprine (Vasodilan) is a beta-adrenergic that directly affects the vascular smooth muscle and results in peripheral vascular dilation. Isoxsuprine relaxes the uterine smooth muscles and is used for treatment of pre-term labor and dysmenorrhea. Isoxsuprine is used extensively in hospitals and private clinics in Iran; however, few studies have reported its safety and efficacy in the prevention of pre-term labor.
Objective: The aim of this study was to assess the effect of maintenance therapy with oral isoxsuprine for the prevention of pre-term labor.
Methods: We undertook a blinded prospective randomized trial of 70 women with singleton pregnancies who presented in pre-term labor between 26 to 34 weeks of gestation. After arresting the contractions with intravenous magnesium sulfate, the patients were randomized into two groups, with the treatment group receiving oral isoxsuprine until 34 weeks of gestation. Response to treatment was assessed by the progression of the pregnancies in both groups. The data were analyzed using SPSS software.
Results: Our results showed that 14 (40%) of the patients in the case group and 12 (34.29%) of patients in the control group had pre-term births, and there was no significant difference between the two groups (P=0.621). Also four women (11.43%) in the case group and five women (14.29%) in the control group delivered before 34 weeks (P=0.721).
Conclusion: Oral isoxsuprine was not effective as a maintenance treatment in preventing pre-term births or in delaying delivery until after 34 weeks. Larger studies are needed to identify the best treatment for pre-term labor.
Clinical Trial Registration: The study is registered in the Iranian Clinical Trial Registry Center (IRCT201101115591N1).
Funding: This study was conducted with financial support provided by the Hormozgan University of Medical Sciences.
References
Steer P. The epidemiology of preterm labour. BJOG: An International Journal of Obstetrics & Gynaecology.
;112(s1):1-3. DOI: 10.1111/j.1471-0528.2005.00837.x. PMID: 15715585.
Von Der Pool BA. Preterm labor: diagnosis and treatment. American family physician. 1998;57(10):2457.
PMID: 9614414.
McPheeters ML, Miller WC, Hartmann KE, Savitz DA, Kaufman JS, Garrett JM, et al. The epidemiology of
threatened preterm labor: a prospective cohort study. American journal of obstetrics and gynecology.
;192(4):1325-9. DOI: 10.1016/j.ajog.2004.12.055. PMID: 15846230.
Simhan HN, Caritis SN. Prevention of preterm delivery. New England Journal of Medicine. 2007;357(5):477- 87. DOI: 10.1056/NEJMra050435. PMID: 17671256.
Haas DM, Caldwell DM ,Kirkpatrick P ,McIntosh JJ ,Welton NJ. Tocolytic therapy for preterm delivery:
systematic review and network meta-analysis. BMJ. 2012;345:e6226. DOI: 10.1136/bmj.e6226. PMID:
Caritis SN. Treatment of preterm labour. Drugs. 1983;26(3):243-61. DOI: 10.2165/00003495-198326030- 00005. PMID: 6137355.
Brazy JE, Pupkin MJ. Effects of maternal isoxsuprine administration on preterm infants. The Journal of
pediatrics. 1979;94(3):444-8. DOI: 10.1016/S0022-3476(79)80599-5.
Tan T, Devendra K, Tan L, Tan H. Tocolytic treatment for the management of preterm labour: a systematic
review. Singapore medical journal. 2006;47(5):361-6. PMID: 16645683.
Lewis R, Mercer B, Salama M, Walsh M, Sibai B. Oral terbutaline after parenteral tocolysis: a randomized,
double-blind, placebo-controlled trial. American journal of obstetrics and gynecology. 1996;175(4):834-7. DOI:
1016/S0002-9378(96)80008-1.
How HY, Hughes SA, Vogel RL, Gall SA, Spinnato JA. Oral terbutaline in the outpatient management of
preterm labor. American journal of obstetrics and gynecology. 1995;173(5):1518-22. DOI: 10.1016/0002- 9378(95)90642-8.
Papatsonis D, Van Geijn H, Ader H, Lange F, Bleker O, Dekker G. Nifedipine and ritodrine in the management
of preterm labor: a randomized multicenter trial. Obstetrics & Gynecology. 1997;90(2):230-4. DOI:
1016/S0029-7844(97)00182-8.
Raymajhi R, Pratap K. A comparative study between nifedipine and isoxsuprine in the suppression of preterm
labour. Kathmanda Univ Med J. 2003;(2):85-90..
Robertson P, Herron M, Katz M, Creasy R. Maternal morbidity associated with isoxsuprine and terbutaline
tocolysis. European Journal of Obstetrics & Gynecology and Reproductive Biology. 1981;11(6):371-8. DOI:
1016/0028-2243(81)90086-1.
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