Treatment with the oxytocin receptor antagonist atosiban in patients with risk of pre-term delivery

Purpose: To evaluate the effects of Atosiban which has been recently made a vailable for routine treatment of patients with threatening pre-term delive ry. Advantage of this tocolytic drug is its specific action on reproductive tissues. Material and Methods: 79 Patients were retrospectively evaluated, diagnoses at admission were pre-term labor (50), preterm rupture of membranes (21), vaginal bleeding (6) and incompetent cervix (6). Gestational age lied betwe en 21st and 33rd week of pregnancy. Pre-term labor was defined as greater t han or equal to4 uterine contractions/30 min and at least one of these 2 ex aminations positive: 1. cervical length < 30 mm examined by vaginal ultraso und, 2. detection of vaginal fetal fibronectin. Tocolytic effectiveness was determined as the number of women having a diagnose of pre-term labor who were still pregnant after 48 hours and after 7 days. The influence on the f requency of contractions before and 3 - 12 hours after start of treatment w as assessed. Maternal side effects, perinatal and neonatal morbidity was ev aluated Results: After 48 hours 86.0% of patients with threatening preterm delivery and after 7 days 80.0% of these patients had not been delivered. Atosiban decreased the frequency of contractions from 8.0 +/- 4.9 (mean sed) before treatment to 2.4 +/- 3.2 contractions/30 min after start of treatment. At t he initial bolus application 33% of patients presented drug related side ef fects as nausea, vertigo and flush over a short period of 1 - 2 minutes. Du ring infusion in 6% of patients side effects possibly related to Atosiban c ould be detected. Perinatal and neonatal outcome was similar to results of children from mothers treated with other tocolytics than Atosiban. No prena tal fetal death could be observed. Conclusion: Atosiban is an effective toc olytic drug in treatment of pre-term labor and pre-term rupture of the memb ranes with significantly less side effects due to its lack of cardiovascula r action.