Hexoprenaline Compared with Atosiban as Tocolytic Treatment for Preterm Labor

Abstract

Introduction Preterm birth is defined as a live birth before 37 weeks of gestation and is associated with increased neonatal morbidity and mortality. The aim of this study is to compare the efficacy of hexoprenaline and atosiban for short- and long-term tocolysis and their effects on neonatal and maternal outcomes.

Methods This retrospective cohort study included women with threatened preterm labor between 24 + 0 and 34 + 0 weeks of gestation without premature rupture of membranes. The tocolytic efficacy of hexoprenaline and atosiban was compared in women receiving one of the two medications for short- and long-term tocolysis. Continuous variables were compared using t-test or Mann–Whitney U test, as appropriate. Comparison of categorical variables between the two groups was done with χ² test after Pearsonʼs and Fisherʼs exact test.

Results 761 women were enrolled in this study; 387 women received atosiban and 374 women received hexoprenaline as their primary tocolytic agent. Atosiban showed a higher efficacy as a primary tocolytic agent (p = 0.000) within 48 hours. As regards long-term tocolysis, there were no differences between the treatment groups (p = 0.466). Maternal side effects such as tachycardia (p = 0.018) or palpitations (p = 0.000) occurred more frequently after the administration of hexoprenaline, while there were no differences between the two drugs administered with regard to any other maternal or neonatal outcome parameter.

Conclusion Our retrospective study shows a significantly higher efficacy of atosiban in the first 48 hours, especially when administered at an early gestational age. There were no significant differences in terms of neonatal outcome but significantly more maternal adverse effects during the administration of hexoprenaline.

Zusammenfassung

Einleitung Frühgeburtlichkeit ist definiert als eine Geburt vor vollendeter 37. Schwangerschaftswoche und ist assoziiert mit einer erhöhten Morbidität und Mortalität der Kinder. Ziel dieser Studie ist der Vergleich der Wirksamkeit von Hexoprenalin und Atosiban als Kurz- und Langzeittokolyse sowie die Auswirkungen auf das kindliche und maternale Outcome.

Methoden In dieser retrospektiven Kohortenstudie wurden Schwangere mit Frühgeburtsbestrebungen zwischen der 24 + 0 und 34 + 0 Schwangerschaftswoche ohne vorzeitigen Blasensprung eingeschlossen. Die tokolytische Wirksamkeit von Atosiban und Hexoprenalin sowie die Wirksamkeit der Kurz- bzw. Langzeittokolyse wurden verglichen. Die Daten wurden mittels SPSS-Software ausgewertet und zum Vergleich der Daten wurde der t-Test oder der Mann-Whitney U-Test verwendet.

Ergebnisse Es wurden 761 Frauen in die Studie eingeschlossen; 387 Frauen erhielten Atosiban und 374 Frauen Hexoprenalin. Atosiban zeigte eine bessere Wirksamkeit als Hexoprenalin innerhalb von 48 Stunden (p = 0,000). Es zeigte sich kein Unterschied in der Wirksamkeit der beiden Medikamente als Langzeittokolytika (p = 0,466). Maternale Nebenwirkungen wie Tachykardie (p = 0,018) oder Palpitationen (p = 0,000) traten vermehrt nach der Gabe von Hexoprenalin auf. Sowohl im kindlichen Kurzzeit- als auch Langzeit-Outcome zeigten sich keine Unterschiede zwischen den beiden verabreichten Medikamenten.

Schlussfolgerung In unseren Ergebnissen zeigte sich eine signifikant bessere Wirksamkeit von Atosiban bei vorzeitigen Wehen innerhalb von 48 Stunden bei einer Applikation im niedrigeren Gestationsalter. Es zeigten sich keine wesentlichen Unterschiede in Bezug auf das neonatale Outcome, aber signifikant vermehrt maternale Nebenwirkungen während der Gabe von Hexoprenalin.

Key words

tocolysis - atosiban - hexoprenaline - efficacy

Schlüsselwörter

Tokolyse - Atosiban - Hexoprenalin - Wirksamkeit

Publication History

Received: 07 October 2021

Accepted after revision: 10 April 2022

Article published online:
10 August 2022

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