Relationship between maternal mortality and ritodrine hydrochloride as a tocolytic agent in Japan.
J Obstet Gynaecol Res
; 50(7): 1111-1117, 2024 Jul.
Article
em En
| MEDLINE
| ID: mdl-38627884
ABSTRACT
AIM:
In Japan, unlike Western countries, tocolytic agents are administered in long-term protocols to treat threatened preterm labor. Evaluating the side effects of this practice is crucial. We examined whether ritodrine hydrochloride had been administered in cases of maternal death, aiming to investigate any relationship between ritodrine administration and maternal death.METHODS:
This retrospective cohort study used reports of maternal deaths from multiple institutions in Japan between 2010 and 2020. Data on the reported cases were retrospectively analyzed, and data on the route of administration, administered dose, and clinical findings, including causes of maternal death, were extracted. The amount of tocolytic agents was compared between maternal deaths with ritodrine administration and those without.RESULTS:
A total of 390 maternal deaths were reported to the Maternal Death Exploratory Committee in Japan during the study period. Ritodrine hydrochloride was administered in 32 of these cases. The frequencies (n) and median doses (range) of oral or intravenous ritodrine hydrochloride were 34.4% (11) and 945 (5-2100) mg and 84.4% (27) and 4032 (50-18 680) mg, respectively. Frequencies of perinatal cardiomyopathy, cerebral hemorrhage, diabetic ketoacidosis, and pulmonary edema as causes of maternal death were significantly higher with ritodrine administration than without it.CONCLUSIONS:
Our results suggest a relationship between long-term administration of ritodrine hydrochloride and an increased risk of maternal death due to perinatal cardiomyopathy, cerebral hemorrhage, diabetic ketoacidosis, and pulmonary edema. In cases where ritodrine should be administered to prevent preterm labor, careful management and monitoring of maternal symptoms are required.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ritodrina
/
Tocolíticos
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Mortalidade Materna
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Asia
Idioma:
En
Revista:
J Obstet Gynaecol Res
Assunto da revista:
GINECOLOGIA
/
OBSTETRICIA
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Japão