الفهرس 
Aim of the workOnly 14 pages are availabe for public view
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Abstract
This study started with a review of literature on pretenn labour definition, etiology, theories of
parturition, diagnosis and management of pretenn labour.
We focussed on the role of ritodrine and glyceryl trinitrate in the treatment of pretenn labour,
concerning their chemistry, plasmacokinetics, dosage, administration, contraind icat ions and side
effects.
Ritodrine primarily acts on myometiral receptors causing a decrease in both intensity and frequency
of u terine contract ions. Glyceryl trin iti:ate, a nitric oxide (NO) donor, has the ability to
relax the smooth muscles of the uterus by reducing calcium stores through guanosine monophosphate
pathway present in the urerus.
The aim of this work was to evaluate the role of transdermal glyceryl trinitrate and to compare
between it and ritodrine regarding their efficacy and reliability in the treatment of pretenn
labour. The study was carried on
40 pregnant females with gestational ages ranging from 24 to 36 weeks attending El Shatby
University Maternity Hospital. They all suffered painful regular contractions at 2 or more every I
0 minutes for more than one hour. The patients were allocated to two groups; .group I (receiving
ritodrine) and group II (receiving glyceryl trinitrate) each group included twenty patients.
Proper history taking, a full clinical examination (general, abdominal and vaginal), routine
investigations and ultrasonographic scanning were conducted on all cases. They were hospitalized
for about 72 hours, during which, group I received ritodrine intravenous infusion at a rate 0.05
mg/min while group II received 10 mg glyceryl trinitrate patches directly applied to the skin of
the abdomen.
Detennination of the baseline maternal and fetal heart rates (MHR, FHR ), maternal mean arterial
pressu re (MAP) was done. Also, a cardiotocagraphic trace was done before the start of treatment.
Clin ical follow up was caJTied on by measuring frequency of uterine contractions and fetal heart
rate using a cardiotocagram . Maternal heart rate, mean arterial pressure and side effects were
monitored regularly over the course of treatment.
Treatment was continued for 24 hours after cessation of contractions or progress of labour to
delivery. This usually occurred in a maximum of
48 hours. At the end of the study the results were tabulated, being as follows:
Glyceryl trinitrate significantly reduced the frequency of contractions after 1 hour 111
companson to ritodrine. There was no significant difference between both groups concerning
prolongation of pregnancy.
Both groups showed a significant DROP of MAP from baseline but not over the course of treatment.
Ritodrine showed a significant increase in MHR and FHR than glyceryl trinitrate (GTN) over the
course of treatment.
Concerning side effects ritodrine showed a significant higher percentage over GTN in causing
headache. This headache usually responded to analgesics.