Bolus tocolysis: treatment of preterm labor with pulsatile administration of a beta-adrenergic agonist

Am J Obstet Gynecol. 1989 Mar;160(3):713-7. doi: 10.1016/s0002-9378(89)80066-3.

Abstract

The treatment of premature labor with beta-adrenergic substances is complicated by side effects. Although most human control mechanisms are pulsatile, therapy is usually administered continuously. We designed a microprocessor-controlled pump to allow pulsatile tocolytic infusion, hoping to reduce the total dose and thus the side effects. In 33 patients pulsatile bolus tocolysis was compared with continuous tocolysis in a control group of 38 patients. Bolus tocolysis required considerably less beta-sympathomimetic agent for comparable therapeutic success (median dosage 3.0 versus 15.9 mg, p less than 0.001). Duration of therapy under bolus tocolysis was also significantly shorter (p less than 0.05). Birth weight was higher after bolus tocolysis (median 3070 versus 2580 gm, p = 0.05). Additional indicators favored bolus tocolysis but were not statistically significant: a longer gestational period, fewer infants weighing less than 2500 gm, and a lower incidence of respiratory distress syndrome. Pulmonary edema occurred in one patient during continuous tocolysis.

Publication types

  • Comparative Study

MeSH terms

  • Adrenergic beta-Agonists / administration & dosage*
  • Adrenergic beta-Agonists / therapeutic use
  • Female
  • Fenoterol / administration & dosage*
  • Fenoterol / therapeutic use
  • Humans
  • Infusion Pumps
  • Infusions, Intravenous
  • Obstetric Labor, Premature / drug therapy*
  • Pregnancy
  • Pregnancy Outcome
  • Tocolysis*

Substances

  • Adrenergic beta-Agonists
  • Fenoterol