The effects of the tocolytics atosiban and nifedipine on fetal movements, heart rate and blood flow

@article{deHeus2009TheEO,
  title={The effects of the tocolytics atosiban and nifedipine on fetal movements, heart rate and blood flow},
  author={R. de Heus and Eduard J. H. Mulder and Jan B. Derks and Gerard H. A. Visser},
  journal={The Journal of Maternal-Fetal \& Neonatal Medicine},
  year={2009},
  volume={22},
  pages={485 - 490}
}
Background. The choice of first-line tocolytic agent is a topic of worldwide debate. The oxytocin receptor antagonist atosiban and the calcium antagonist nifedipine appear to be effective in postponing delivery. However, information is lacking on their possible effects on the fetal biophysical profile. Objective. To study the direct fetal effects of tocolysis with atosiban or nifedipine combined with a course of betamethasone. Method. We performed a randomised controlled study including women… 
Assessment of Maternal Nifedipine as a Tocolytic Agent on the Doppler Indices of Uterine and Fetal Umbilical and Middle Cerebral Arteries
TLDR
Nifedipine tocolysis is associated with a reduction in RI and PI in the MCA, and an increase in RI in uterine arteries after 24 h but returning to baseline within 72 h, with no long-term effect on fetomaternal circulation in pregnant women at risk of preterm delivery.
A COMPARISON OF TOCOLYSIS WITH NIFEDIPINE OR ATOSIBAN IN PRETERM
TLDR
The effectiveness of nifedipine and atosiban in pregnancy prolongation for 48 hours in threatened preterm labor is comparable, however, lower tolerability of niftipine limits its applicability.
Effect of tocolytic drugs on fetal heart rate variability: a systematic review
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    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2017
TLDR
In order to prevent iatrogenic preterm labor, the effects of tocolytic drugs on fetal HRV should be taken into account when monitoring these fetuses.
Effect of Dexamethasone on Antepartum Cardiotocography
TLDR
Dexamethasone induces transient suppression of fetal heart rate parameters on day 2 after administration that mimics fetal compromise, and awareness of this phenomenon is important to avoid iatrogenic delivery of preterm fetuses.
Tocolysis with nifedipine versus atosiban and perinatal outcome: an individual participant data meta-analysis
TLDR
In this IPDMA, there were no differences in composite outcome between nifedipine and atosiban in the treatment of threatened preterm birth, however, the non-significant higher mortality after administering nifEDipine warrants further investigation of the use of nifingipine as a tocolytic drug.
Preliminary report of 48-hours Atosiban administration in spontaneous preterm labor - Doppler blood flow assessment of placental and fetal circulation.
TLDR
This first evaluation of placental and fetal circulation with assessment of cardiac hemodynamic function during 48-hours administration of Atosiban seems not to alter uterine nor fetal arterial blood flow pattern seriously and Hemodynamic cardiac activity in fetuses has remained unaffected.
Tocolytic indomethacin: effects on neonatal haemodynamics and cerebral autoregulation in the preterm newborn
TLDR
Prenatally administered indomethacin, given as a tocolytic in doses of 50–150 mg per day, improved transitional circulation in very preterm infants by significantly raising the MABP and did not have an effect on the ability to autoregulate the cerebral circulation.
The influence of nifedipine in pre-term labor therapy on blood flow parameters in fetal middle cerebral artery , umbilical artery and in maternal uterine arteries
The aim of this study was to evaluate the effect of nifedipine, drug that inhibits uterine contractions, on parameters of blood flow in the middle cerebral artery of the fetus and of the maternal
Calcium Channel Blockers as Tocolytics: Principles of Their Actions, Adverse Effects and Therapeutic Combinations
TLDR
The available human and animal studies suggest that the combination of CCBs with β-AR agonists is beneficial, although such combinations can pose risk of pulmonary oedema in multiple pregnancies and maternal cardiovascular diseases.
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