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2016 ; 13
(2
): 85-89
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A comparison of the effects of the most commonly used tocolytic agents on
maternal and fetal blood flow
#MMPMID28913098
Güden M
; Akkurt MÖ
; Eri? Yalç?n S
; Co?kun B
; Akkurt I
; Yavuz A
; Yirci B
; Kandemir NÖ
Turk J Obstet Gynecol
2016[Jun]; 13
(2
): 85-89
PMID28913098
show ga
OBJECTIVE: To investigate the effects of two tocolytics, nifedipine and magnesium
sulfate, on Doppler indices in maternal and fetal vessels. MATERIALS AND METHODS:
We recruited 100 pregnant women with preterm birth between 24-36 gestational
weeks who were admitted to our tertiary center over a two-year period. Patients
were allocated to nifedipine (n=49) and magnesium sulfate (n=51) groups and
Doppler indices of umbilical, middle cerebral, uterine arteries, and ductus
venosus were measured before and after tocolysis. RESULTS: There were no
differences between the groups in terms of maternal age, gestational week, body
mass indexes, cervical dilation, effacement at admission, birth weights and
latency periods until birth. Nifedipine decreased resistance indexes in uterine
arteries but magnesium sulfate increased resistance especially in the right
uterine artery. Nifedipine significantly decreased systole to diastole and
resistance index in the umbilical artery, magnesium sulfate increased systole to
diastole and resistance index but this was not statistically significant.
Nifedipine acted variably on resistance index and pulsatility index in the ductus
venosus; however, magnesium sulfate increased resistance. Nifedipine decreased
pulsatility index in the middle cerebral artery, contrary to magnesium sulfate
with which it increased. CONCLUSION: Nifedipine had favorable effects on maternal
and fetal vessel indexes but magnesium sulfate increased resistance. Despite the
proposed neuroprotective benefits of magnesium sulfate, nifedipine seems to be a
better and safer tocolytic agent than magnesium sulfate due to its positive
beneficial effects on maternal and fetal vessels.