ABSTRACT

Aim: To compare the efficiency of two tocolytic drugs, oxytocin antagonist (oxytocin) with those of beta-adrenergic agonist (salbutamol) in continuation of pregnancy.

Methods: A randomized clinical trial study was carried out at the Al Batool Teaching Hospital, Mosul City-Iraq, all women belonged to age group (18 to 35) years who admitted delivery room with gestational age between (24-34) weeks of pregnancy. Two hundred pregnant women with preterm labor were joined in this study during the period of (January 2009-March, 2010). The women were divided randomly into two groups,(100) women Received intravenous infusion beta-agonist drug salbutamol sulfate  (ventolin obstetric injection) .The pulse rate for women and for fetal were observed. the infusion amount were controlled to avoid women heart rates to excess of 120 beat per/min. Oxytocin  is administered IV in 3 successive stages : an initial bolus dose 0.9 ml intravenous infusion (6.75mg) over 1 minute with oxytocin  7.5mg/ml solution for injection ,followed by continuous high dose infusion of( 300microgram/minute) of oxytocin  injection with infusion rate of 24ml/hour (oxytocin e dose 18mg/hour) over 3 hours period followed by a lower dose of oxytocin  (subsequent infusion100microgram/minute ) with infusion rate of 8ml/hour(oxytocin e dose 6mg/hour) for up to 48 hours. Fetal pulse and uterine withdrawals just as maternal circulatory strain and heartbeat rate were surveyed like clockwork for all member patients, if maternal heartbeat rate >120 beat/minute, fetal pulse >160 beat/minute, maternal dyspnea or chest torment built up the administration ended. The 48-hour delay in delivery was the most prominent result of this study.

Results: The study finding reveals that mean age of Salbutamol and Atosiban groups is  (24.22+3.54), (25.54+1.14) respectively. Gestational age for group 1 is (29.22+0.42) and for group 2(30.11+0.77). Salbutamol delayed Delivery more than 48h in (44%) of women while Atosiban delayed (26%).Salbutamol administration associated with maternal tachycardia in 44% of women, and in comparative with Atosiban,  only 16 % of women record tachycardia. Neonatal respiratory distress observed in 16% in group 1 and 12% in group 2.

Conclusion: The oxytocin antagonist atosiban, with a comparable neonatal and child health profile, was found to be better tolerated by both mother and fetus than salbutamol and atosiban was as effective as salbutamol in preventing threatened preterm birth. This research assists in the clinical use of atosiban in preterm labor therapy.