Vasodilation Elicited by Isoxsuprine, Identified by High-Throughput Virtual Screening of Compound Libraries, Involves Activation of the NO/cGMP and H2S/KATP Pathways and Blockade of α1-Adrenoceptors and Calcium Channels.

Recently, our research group demonstrated that uvaol and ursolic acid increase NO and H2S production in aortic tissue. Molecular docking studies showed that both compounds bind with high affinity to endothelial NO synthase (eNOS) and cystathionine gamma-lyase (CSE). The aim of this study was to identify hits with high binding affinity for the triterpene binding-allosteric sites of eNOS and CSE and to evaluate their vasodilator effect. Additionally, the mechanism of action of the most potent compound was explored. A high-throughput virtual screening (HTVS) of 107,373 compounds, obtained from four ZINC database libraries, was performed employing the crystallographic structures of eNOS and CSE. Among the nine top-scoring ligands, isoxsuprine showed the most potent vasodilator effect. Pharmacological evaluation, employing the rat aorta model, indicated that the vasodilation produced by this compound involved activation of the NO/cGMP and H2S/KATP signaling pathways and blockade of α1-adrenoceptors and L-type voltage-dependent Ca2+ channels. Incubation of aorta homogenates in the presence of isoxsuprine caused 2-fold greater levels of H2S, which supported our preliminary in silico data. This study provides evidence to propose that the vasodilator effect of isoxsuprine involves various mechanisms, which highlights its potential to treat a wide variety of cardiovascular diseases.

Analysis of effect isoxsuprine hydrochloride and nicotine in the Transverse Rectus Abdominis Myocutaneous flap (TRAM) in rats.

PURPOSE: To evaluate the effects of isoxsuprine and nicotine on TRAM. METHODS: Forty eight 48 Wistar rats distributed into four Groups (n=12). All rats received medication managed daily for 20 days: saline solution (SA), nicotine solution (NI), isoxsuprine solution (IS) and nicotine solution (NI) + isoxsuprine solution (IS). On day 21st the rats were submitted to the caudally based, right unipedicled TRAM flap and after 48 hours, made the macroscopic evaluation of the surface of the flap, photographic documentation and collection of material for histology. Data from macroscopic evaluation were analyzed by ANOVA and microscopic evaluation by Kruskal-Wallis test, with significance level of 5%. RESULTS: In the macroscopic evaluation of isoxsuprine Group retail presented absolute numbers: final area (p=0.001*) and viable area (p=0.006*) with the highest values; necrosis (p=0.001*) had the lowest value. Microscopic examination revealed no significant findings in the study of TRAM under the action of isoxsuprine and nicotine to the percentage of necrosis in the left and right cranial and caudal regions. CONCLUSIONS: There was significant improvement in viability of TRAM using the isoxsuprine solution alone. No influence using nicotine alone and in association with isoxsuprine.

Analysis of effect isoxsuprine hydrochloride and nicotine in the Transverse Rectus Abdominis Myocutaneous flap (TRAM) in rats

PURPOSE: To evaluate the effects of isoxsuprine and nicotine on TRAM. METHODS: Forty eight 48 Wistar rats distributed into four Groups (n=12). All rats received medication managed daily for 20 days: saline solution (SA), nicotine solution (NI), isoxsuprine solution (IS) and nicotine solution (NI) + isoxsuprine solution (IS). On day 21st the rats were submitted to the caudally based, right unipedicled TRAM flap and after 48 hours, made the macroscopic evaluation of the surface of the flap, photographic documentation and collection of material for histology. Data from macroscopic evaluation were analyzed by ANOVA and microscopic evaluation by Kruskal-Wallis test, with significance level of 5%. RESULTS: In the macroscopic evaluation of isoxsuprine Group retail presented absolute numbers: final area (p=0.001*) and viable area (p=0.006*) with the highest values; necrosis (p=0.001*) had the lowest value. Microscopic examination revealed no significant findings in the study of TRAM under the action of isoxsuprine and nicotine to the percentage of necrosis in the left and right cranial and caudal regions. CONCLUSIONS: There was significant improvement in viability of TRAM using the isoxsuprine solution alone. No influence using nicotine alone and in association with isoxsuprine.(AU)

Analysis of effect isoxsuprine hydrochloride and nicotine in the Transverse Rectus Abdominis Myocutaneous flap (TRAM) in rats

PURPOSE: To evaluate the effects of isoxsuprine and nicotine on TRAM. METHODS: Forty eight 48 Wistar rats distributed into four Groups (n=12). All rats received medication managed daily for 20 days: saline solution (SA), nicotine solution (NI), isoxsuprine solution (IS) and nicotine solution (NI) + isoxsuprine solution (IS). On day 21st the rats were submitted to the caudally based, right unipedicled TRAM flap and after 48 hours, made the macroscopic evaluation of the surface of the flap, photographic documentation and collection of material for histology. Data from macroscopic evaluation were analyzed by ANOVA and microscopic evaluation by Kruskal-Wallis test, with significance level of 5%. RESULTS: In the macroscopic evaluation of isoxsuprine Group retail presented absolute numbers: final area (p=0.001*) and viable area (p=0.006*) with the highest values; necrosis (p=0.001*) had the lowest value. Microscopic examination revealed no significant findings in the study of TRAM under the action of isoxsuprine and nicotine to the percentage of necrosis in the left and right cranial and caudal regions. CONCLUSIONS: There was significant improvement in viability of TRAM using the isoxsuprine solution alone. No influence using nicotine alone and in association with isoxsuprine. .

Interventions for treating leg ulcers in people with sickle cell disease.

BACKGROUND: The frequency of skin ulceration makes it an important contributor to the morbidity burden in people with sickle cell disease. Many treatment options are available to the healthcare professional, although it is uncertain which treatments have been assessed for effectiveness in people with sickle cell disease. OBJECTIVES: To assess the clinical effectiveness and safety of interventions for treating leg ulcers in people with sickle cell disease. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register.We searched LILACS (1982 to August 2012), the African Index Medicus (up to August 2012), ISI Web of Knowledge (1985 to August 2012), and the Clinical Trials Search Portal of the World Health Organization (August 2012). We checked the reference lists of all the trials identified. We also contacted those groups or individuals who may have completed relevant randomised trials in this area.Date of the last search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register: 21 July 2014; date of the last search of the Cochrane Wounds Group Trials Register: 18 September 2014. SELECTION CRITERIA: Randomised controlled trials of interventions for treating leg ulcers in people with sickle cell disease compared to placebo or an alternative treatment. DATA COLLECTION AND ANALYSIS: Two authors independently selected studies for inclusion. All three authors independently assessed the risk of bias of the included studies and extracted data. MAIN RESULTS: Six studies met the inclusion criteria (198 participants with 250 ulcers). Each trial investigated a different intervention and within this review we have grouped these as systemic pharmaceutical interventions (L-cartinine, arginine butyrate, isoxsuprine) and topical pharmaceutical interventions (Solcoseryl(®) cream, RGD peptide dressing, topical antibiotics). Three interventions reported on the change in ulcer size (arginine butyrate, RGD peptide, L-cartinine). Of these, RGD peptide matrix significantly reduced ulcer size compared with a control group, mean reduction 6.60cm(2) (95% CI 5.51 to 7.69; very low quality of evidence). Three trials reported on the incidence of complete closure (isoxsuprine, arginine butyrate, RGD peptide matrix; ranging between low and very low quality of evidence). None reported a significant effect. No trial reported on: the time to complete ulcer healing; ulcer-free survival following treatment for sickle cell leg ulcers; quality of life measures; or incidence of amputation. There was no reported information on the safety of these interventions. AUTHORS' CONCLUSIONS: There is evidence that a topical intervention (RGD peptide matrix) reduced ulcer size in treated participants compared to controls. This evidence of efficacy is limited by the generally high risk of bias associated with these reports.We planned to analyse results according to general groups: pharmaceutical interventions (systemic and topical); and non-pharmaceutical interventions (surgical and non-surgical). However, we were unable to pool findings due to the heterogeneity in outcome definitions, and inconsistency between the unit of randomisation and the unit of analysis. This heterogeneity, along with a paucity of identified trials, prevented us performing any meta-analyses.This Cochrane review provides some evidence for the effectiveness of one topical intervention - RGD peptide matrix. However, this intervention was assessed as having a high risk of bias due to inadequacies in the single trial report. Other included studies were also assessed as having a high risk of bias. We recommend that readers interpret the trial results with caution. The safety profile of the all interventions was inconclusive.

Interventions for treating leg ulcers in people with sickle cell disease.

BACKGROUND: The frequency of skin ulceration makes it an important contributor to the morbidity burden in people with sickle cell disease. Many treatment options are available to the healthcare professional, although it is uncertain which treatments have been assessed for effectiveness in people with sickle cell disease. OBJECTIVES: To assess the clinical effectiveness and safety of interventions for treating leg ulcers in people with sickle cell disease. SEARCH METHODS: We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's Haemoglobinopathies Trials Register.We searched LILACS (1982 to August 2012), the African Index Medicus (up to August 2012), ISI Web of Knowledge (1985 to August 2012), and the Clinical Trials Search Portal of the World Health Organization (August 2012). We checked the reference lists of all the trials identified. We also contacted those groups or individuals who may have completed relevant randomised trials in this area.Date of the last search of the Group's Haemoglobinopathies Trials Register: 25 May 2012. SELECTION CRITERIA: Randomised controlled trials of interventions for treating leg ulcers in people with sickle cell disease compared to placebo or an alternative treatment. DATA COLLECTION AND ANALYSIS: Two authors independently selected studies for inclusion. All three authors independently assessed the risk of bias of the included studies and extracted data. MAIN RESULTS: Six studies met the inclusion criteria (198 participants with 250 ulcers). Each trial investigated a different intervention and within this review we have grouped these as systemic pharmaceutical interventions (L-cartinine, arginine butyrate, isoxsuprine) and topical pharmaceutical interventions (Solcoseryl(®) cream, RGD peptide dressing, topical antibiotics). Three interventions reported on the change in ulcer size (arginine butyrate, RGD peptide, L-cartinine). Of these, RGD peptide matrix significantly reduced ulcer size compared with a control group, mean reduction 6.60cm(2) (95% CI 5.51 to 7.69). Three trials reported on the incidence of complete closure (isoxsuprine, arginine butyrate, RGD peptide matrix). None reported a significant effect. No trial reported on: the time to complete ulcer healing; ulcer-free survival following treatment for sickle cell leg ulcers; quality of life measures; or incidence of amputation. There was no reported information on the safety of these interventions. AUTHORS' CONCLUSIONS: There is evidence that a topical intervention (RGD peptide matrix) reduced ulcer size in treated participants compared to controls. This evidence of efficacy is limited by the generally high risk of bias associated with these reports.We planned to analyse results according to general groups: pharmaceutical interventions (systemic and topical); and non-pharmaceutical interventions (surgical and non-surgical). However, we were unable to pool findings due to the heterogeneity in outcome definitions, and inconsistency between the unit of randomisation and the unit of analysis. This heterogeneity, along with a paucity of identified trials, prevented us performing any meta-analyses.This Cochrane review provides some evidence for the effectiveness of one topical intervention - RGD peptide matrix. However, this intervention was assessed as having a high risk of bias due to inadequacies in the single trial report. Other included studies were also assessed as having a high risk of bias. We recommend that readers interpret the trial results with caution. The safety profile of the all interventions was inconclusive.

Tocólisis con clorhidrato de isoxuprina o nifedipina en la amenaza de parto pretérmino / Tocolysis with isoxuprine hydrochloride or nifedipine in preterm labor

Comparar la eficacia del clorhidrato de isoxuprina o la nifedipina en la tocólisis de la amenaza de parto pretérmino. Se seleccionaron 82 pacientes con edad gestacional entre 24 y 34 semanas y diagnóstico de amenaza de parto pretérmino. Las pacientes se dividieron al azar en 2 grupos para recibir clorhidrato de isoxuprina (grupo A) o nifedipina (grupo B). Se determinaron el tiempo de cese de las contracciones, tensión arterial materna, concentraciones de glucosa y efectos adversos maternos. Maternidad "Dr. Nerio Belloso", Hospital Central "Dr. Urquinaona", Maracaibo. Estado Zulia. Se logró una tocólisis efectiva en las primeras 24 horas en 61,0 por ciento y 70,7 por ciento de las pacientes del grupo A y B, respectivamente (P = ns). Después de 7 días de tratamiento, 36,6 por ciento de las pacientes en el grupo A y 31,7 por ciento de las pacientes en el grupo B aun permanecían sin contracciones (P = ns). Se logró un retraso del parto hasta las 34 semanas o más en 26,8 por ciento y 29,3 por ciento de las pacientes de los grupos A y B, respectivamente. En el grupo de pacientes tratadas con clorhidrato de isoxuprina se observó un aumento significativo de las concentraciones séricas de glucosa (P < 0,001). Los efectos adversos maternos fueron significativamente más frecuentes en el grupo de clorhidrato de isoxuprina después de 2 y 24 horas de tratamiento (P < 0,05). La nifedipina es igual de efectiva que el clorhidrato de isoxuprina en la tocólisis de la amenaza de parto pretérmino y produce menos efectos adversos

To compare the efficacy of isoxuprine clorhidrate or nifedipine in tocolysis of threatened preterm labor. 82 patients with a gestational age between 24 and 34 weeks and threatened preterm labor diagnosis were selected. Patients were randomly divided in 2 groups to receive isoxuprine clorhidrate (group A) or nifedipine (group B). Time of cease of contractions, maternal blood pressure, glucose concentrations and maternal adverse effects were determined. Maternidad "Dr. Nerio Belloso", Hospital Central "Dr. Urquinaona", Maracaibo. Estado Zulia. An effective tocolysis was obtained within 24 hours in 61.0 percent and 70.7 percent for patients in group A and B, respectively (P = ns). After 7 days of treatment, 36.6 percent of patients in group A and 31,7 percent of patients in group B were still without contractions (P = ns). A delay in labor till 34 weeks or more was made in 26.8. percent and 29.3 percent of patients in group A and B, respectively. In the group of patients treated with isoxuprine clorhidrate a significant raise of glucose concentrations was observed (P < 0.001). Maternal adverse effects were significant more frequent in isoxuprine clorhidrate group after 2 and 24 hours of treatment (P < 0,05). Nifedipine has a similar effectivity than isoxuprine clorhidrate for tocolysis in threatened preterm labor and produces less adverse effects

An analgesic evaluation of isoxsuprine in horses.

Isoxsuprine is used clinically to treat navicular disease and laminitis in horses. Although it is thought to increase digital and laminar blood flow, isoxsuprine's mechanism of action remains controversial, and analgesia has been suggested recently as such possible mechanism. This research investigated the analgesic potential of isoxsuprine in healthy horses submitted to a mechanical nociceptive test. Isoxsuprine (1.2 mg/kg), xylazine (1.1 mg/kg), distilled water : ethanol 95% (2 : 1, v/v, 20 ml) and saline (0.9%, 20 ml) were injected intravenously, and nociceptive thresholds were measured over 90 min. Only xylazine significantly increased nociceptive thresholds, confirming that alpha(2)-adrenoceptor agonists produce analgesia in horses. Our results do not support an analgesic mechanism of action for isoxsuprine in horses, suggesting that other mechanisms might account for the clinical efficacy of this drug or that mechanical nociceptive testing may not be sufficiently sensitive to demonstrate an analgesic effect for this drug.

O controle do trabalhode parto prematuro no Hospital Universitário da Universidade de Säo Paulo / The control of premature labor. University Hospital of the Säo Paulo University

O parto prematuro é responsável pela maioria das mortes perinatais. A cauda do trabalho de parto prematuro é na maioria das vezes de causa desconhecida. É feita uma revisäo dos aspectos do parto prematuro e dos agentes tocolíticos usados na inibiçäo do trabalho de parto prematuro. Numerosos agentes têm sido utilizados, mas nenhum deles tem se mostrado como ideal. Os B-adrenégicos tais como a isoxsuprina, aritidrina, a terbutalina e o salbutamol parecem ser os mais efetivos e seguros. Outras drogas como o sulfato de magnésio, as prostaglandinas, os antagonistas de cálcio e da oxitocina säo também inibidores do trabalho de parto prematuro, porém menos efetivos e os riscos da sua utilizaçäo necessita de cuidadosa avaliaçäo. Os efeitos colaterais devem ser identificados e controlados. A terapêutica prolongada näo é benéfico para a gestante e para o feto. O Hospital Universitário da USP utiliza a isoxsuprina para a inibiçäo do trabalho de parto prematuro. O protocolo insiste em manter as pacientes internadas em repouso e inicialmente realizar hidrataçäo parenteral seguida de infusäo endovenosa de cinco ampolas de isoxsuprina diluídas em 500 ml de soro glicosado a 5 porcento, iniciando-se com 4 gotas/min (50mcg/min) e aumentando 4 gotas/min a cada 20 minutos (máximo de 40 gotas/min), até atingir a dose necessária para inibir as contraçöes uterinas. Obtida a dose mínima necessária para a inibiçäo das contraçöes , mantemos durante duas horas e reduzimos gradativamente até atingir a dose inicial que é mantida por duas horas. Os efeitos colaterais frequentemente relacionados ao uso da isoxsuprina e que indicam a sua interrupçäo näo foram observados. O trabalho de parto foi interrompido em 90 porcento dos casos num período menor do que 48 horas. Os resultados sugerem que o uso da isoxsuprina pode ser um método seguro e eficaz na inibiçäo do trabalho de parto prematuro, contribuindo para a diminuiçäo da prematuridade e suas conseqüencias.(au)

Uso da isoxsuprina na inibiçäo do trabalho de parto prematuro na clínica obstétrica do Hospital Universitário da Universidade de Säo Paulo / Use of isoxsuprine in the inhibition of premature labor at the Obstetric Clinic of the Hospital Universitário da Universidade de Säo Paulo

Foi realizado um estudo retrospectivo em 41 gestantes submetidas a inibiçäo do trabalho de parto prematuro com isoxsuprina internadas na Clínica Obstétrica do Hospital Universitário da Universidade de Säo Paulo no período de janeiro a dezembro de 1998. Neste período foram internadas 150 gestantes com diagnóstico de trabalho de parto prematuro, das quais 109 apresentavam contra-indicaçöes maternas ou fetais para a inibiçäo. As 41 pacientes restantes foram mantidas em repouso absoluto no leito e inicialmente hidratadas por via parenteral. Após uma hora as pacientes foram reavaliadas e, como as contraçöes uterinas persistiram, iniciamos a infusäo endovenosa de 5 ampolas de isoxsuprina diluídas em 500 ml de soro glicosado a 5 porcento. O trabalho de parto prematuro foi inibido em 37 casos num período inferior a 48 horas. Os efeitos colaterais frequentemente relacionados ao uso da isoxsuprina e que indicam a sua interrupçäo näo foram observados. Estes resultados sugerem que o uso da isoxsuprina pode ser um método seguro e eficaz n inibiçäo do trabalho de parto prematuro, contribuindo para a diminuiçäo da prematuridade e suas consequências.(au)

Determinaçäo do limite de decisao do teste imunoenzimático ELISA na análise de isoxsuprina em controle antidopagem de cavalos de corrida / Determination of decision limit of immunoenzymatic test ELISA for the analysis of isoxsuprine in antidoping control of horseracing

O uso de ensaios imunoenzimáticos tipo Elisa (Enzyme Lynked Immunosorbent Assay), largamente utilizado em laboratórios de controle de dopagem, é aceito apenas como método de triagem, havendo portanto, a necessidade de uma técnica mais apurada para confirmação. Devido à grande sensibilidade da técnica ELISA em relação às análises por CG/EM, torna-se necessária a determinação de um valor, que na técnica ELISA corresponda à menor concentração detectável detectável no método de confirmação no método de confirmação, facilitando com isto a seleção das amostras suspeitas. O presente trabalho tem como objetivo definir este valor, à partir do qual a amostra será submetida à técnica de Cromatografia a Gás com Espectrometria de Massa (CG/EM). Este limite de decisão empregado na técnica Elisa, irá minimizar o custo operacional, pois apenas as amostras que apresentem valores acima deste limite serão submetidas ao método de confirmação.

Isoxuprina en la hipertensión del embarazo / Isoxuprine in the hypertension of pregnancy

El objetivo del presente trabajo es el de demostrar que la isoxuprina es útil en el manejo de la hipertensión del embarazo y que no tiene efectos adversos sobre el binomio materno fetal. Se trata de un estudio prospectivo, transversal y aleatorio, relacionado con la Unidad de Cuidados Intensivos del Hospital de Gineco-Obstetricia del Centro Médico Nacional La Raza IMSS. Se estudiaron al azar 50 pacientes, de acuerdo al protocolo de manejo del hospital, que ingresaron con diagnóstico de toxemia severa (embarazo de 24 semanas con hipertensión, edema, albuminuria, convulsiones y/o estado de coma sin patología previa o concomitante). Se administró la isoxuprina 50mg en 250 ml de solución glucosada al 5 por ciento a dosis respuesta y se valoró el efecto hipotensor en función de tiempo y dosis promedio, así como sus efectos sobre la frecuencia cardiaca materna y fetal con respecto a la basal; se valoró calificación APGAR al minuto uno y cinco del nacimiento y se analizó en cuanto a grados de toxemia; por último se comenta el suceso obstétrico. Los resultados demuestran una disminución significativa de la presión arterial media (PAM), logrando control de la misma a los quince minutos y con una dosis de nueve gotas (0.029 mcg) en promedio, indicando a la vez que no hay efectos adversos sobre el binomio. Se concluye que la isoxuprina es un hipotensor eficaz, rápido, de fácil manejo, que no tiene efectos indeseables sobre la frecuencia cardiaca materna y fetal, niveles de glucemia, hemorragia obstétrica y calificación de APGAR

[Isoxsuprine in hypertension during pregnancy]. / Isoxuprina en la hipertensión del embarazo.

The objective of this paper is to demonstrate that isoxsuprine is an effective, quick hypotensive of easy management in the hypertension of pregnancy that does not have adverse effects on the mother-fetus binomial. This study was carried out at the Obstetric Intensive Care Unit at the Gyneco-Obstretrics Hospital in the Centro Médico Nacional La Raza of the IMSS. Fifty patients were chosen and managed according to the protocol management of the hospital; they had a diagnosis of severe toxemia or preeclampsia in patients with 24 weeks or more of pregnancy, with hypertension, edema, convulsions and/or coma state or without concomitant or previous pathological states. All of the patients received isoxsuprine (50 mg in 250 ml of DW5%). We evaluated the hypotensive effect of isoxsuprine according to the time and average dose administered, and its effect on the mother and fetus heart frequency according to the basal values. We valued the APGAR score at minute one and minute five, seconds after the delivery. We analyzed according to the degrees of toxemia and at the end of the obstetric event. We demonstrated a significant decrease in the arterial tension after administration fifteen minutes later with a dose of nine drops (0.29 mcg/min) average and demonstrated at the same time that there are no adverse effects on the mother fetus binomial. Isoxsuprine is an affective, quick and economical hypotensive of easy management that has no adverse effects on mother-fetus glycemia, obstetric bleeding and APGAR score.

Efectos hemodinámicos de la isoxsuprina en el paciente en estado crítico con sepsis abdominal / Hemodynamic effects of isoxsuprine in the critically ill patient with abdominal sepsis

Introducción. La sepsis abdominal se acompaña con frecuencia de shock y vasoconstrición severa. Objetivo. Dar a conocer los efectos hemodinamico de la isoxuprina en el paciente con sepsis abdominal y shock. Pacientes y métodos. Evaluamos los efectos de la isoxsuprina en 24 pacientes de una UCI. Se les efectuaron mediciones hemodinámicas antes y después de tratarse con isoxsuprina (1.5 µg/kg.min). Resultados. Después del tratamiento disminuyó el índice de resistencia vasculares sistémicas (2703 ñ 1541 a 1632 ñ 720 din/s.cm-5, p< 0.004) y aumentó el índice cardiaco (3.12 ñ 1.44 a 3.9 ñ 1.15 mL/min, p< 0.04); las resistencias pulmonares, disponibilidad de oxígeno, consumo de oxígeno y el porcentaje de extracción de oxígeno permanecieron sin cambios. Conclusión. Este estudio documental los efectos benéficos de la isoxsuprina en el paciente crítico con sepsis abdominal

Resultados del tratamiento de la amenaza de aborto y parto prematuro con cerclaje y uteroinhibidores / Results pf the treatment of abortion menace and premature labor with cerclages and uteroinhibitors

El presente estudio comprende 60 embarazos con incopetencia ístmico-cervical, tratadas con cerclaje y úteroinhibidores. Sólo se hizo cerclaje cuando se detectaron modificaciones cervicales durante el control del embarazo. Se dividen las pacientes en dos grupos: Primero: cerclajes realizados entre 12 y 20 semanas, y Segundo: cerclajes realizados entre 20 y 32 semanas respectivamente. En el total de tratadas 48 (80%) pasaron las 36 semanas de gestación; 7 (11,7%) fueron partos pretérminos entre 30 y 36 semanas y 5 (8,3%) fueron partos antes de las 30 semanas. Análisis por grupos: cerclajes antes de las 20 semanas (25 casos) 19 (76%) sobrepasaron las 36 semanas; 3 (12%) fueron partos pretérminos entre 30 y 36 semanas; 3 (12%) fueron partos antes de las 30 semanas. Cerclajes después de las 20 semanas: (35 casos), 29 (83%) partos posteriores a las 36 semanas; 4 (11,4%) fueron partos entre 30 y 36 semanas y 2 (5,6%) antes de las 30 semanas. Consideramos que los resultados obtenidos son muy buenos dado que arrojan un 91,6% de éxitos en un grupo de pacientes que entró al programa con grave riesgo de aborto y/o parto prematura

Resultados del tratamiento de la amenaza de aborto y parto prematuro con cerclaje y uteroinhibidores / Results pf the treatment of abortion menace and premature labor with cerclages and uteroinhibitors

El presente estudio comprende 60 embarazos con incopetencia ístmico-cervical, tratadas con cerclaje y úteroinhibidores. Sólo se hizo cerclaje cuando se detectaron modificaciones cervicales durante el control del embarazo. Se dividen las pacientes en dos grupos: Primero: cerclajes realizados entre 12 y 20 semanas, y Segundo: cerclajes realizados entre 20 y 32 semanas respectivamente. En el total de tratadas 48 (80%) pasaron las 36 semanas de gestación; 7 (11,7%) fueron partos pretérminos entre 30 y 36 semanas y 5 (8,3%) fueron partos antes de las 30 semanas. Análisis por grupos: cerclajes antes de las 20 semanas (25 casos) 19 (76%) sobrepasaron las 36 semanas; 3 (12%) fueron partos pretérminos entre 30 y 36 semanas; 3 (12%) fueron partos antes de las 30 semanas. Cerclajes después de las 20 semanas: (35 casos), 29 (83%) partos posteriores a las 36 semanas; 4 (11,4%) fueron partos entre 30 y 36 semanas y 2 (5,6%) antes de las 30 semanas. Consideramos que los resultados obtenidos son muy buenos dado que arrojan un 91,6% de éxitos en un grupo de pacientes que entró al programa con grave riesgo de aborto y/o parto prematura (AU)