OBJECTIVE: In terms of efficacy, several previous studies have shown that the success rate in inhibiting preterm labor was not different between magnesium sulfate and ritodrine. However, there is a paucity of information regarding the efficacy of both medications after consideration of intra-amniotic infection, which is one of the most important prognostic factors in patients of threatened preterm birth. The objective of this study was to compare the efficacy and safety of magnesium sulfate with that of ritodrine in preterm labor. METHODS: In this retrospective cohort study, we included patients who were admitted and treated with either ritodrine or magnesium sulfate with the diagnosis of preterm labor at 24–33.6 weeks of gestational age between January 2005 to April 2015. Patients were divided into 2 groups according to the first-used tocolytics (ritodrine group and magnesium sulfate group). We compared the efficacy and prevalence of side effect in each group. The efficacy of both tocolytics was evaluated in terms of preterm delivery within 48 hours, 7 days, or 37 weeks of gestation and need for 2nd line therapy. RESULTS: A total number of 201 patients were enrolled including 177 cases in ritodrine group and 24 cases in magnesium sulfate group. The efficacy of both tocolytics (preterm delivery within 48 hours, 7 days, or 37 weeks of gestation and need for 2nd line therapy) was not different between the 2 groups of cases. In multivariate analysis, gestational age at treatment, twin gestation, intra-amniotic infection and maternal C-reactive protein (CRP) was associated with treatment failure (preterm delivery within 48 hours), but the type of tocolytics was not significantly associated with treatment failure. The type of side effect was different in the 2 groups, but the frequency of total adverse effect, need for discontinuation of therapy because of maternal adverse effect, and severe adverse effect were not different between the two groups of cases. CONCLUSION: The efficacy and safety of magnesium sulfate was similar to ritodrine, and can be a substitute tocolytics. Additionally, failure of tocolytic therapy was determined by gestational age at treatment, twin gestation, intra-amniotic infection, and maternal CRP, not by the type of tocolytics.
C-Reactive Protein ; Cohort Studies ; Diagnosis ; Female ; Gestational Age ; Humans ; Magnesium Sulfate ; Magnesium ; Multivariate Analysis ; Obstetric Labor, Premature ; Pregnancy ; Premature Birth ; Prevalence ; Retrospective Studies ; Ritodrine ; Tocolysis ; Tocolytic Agents ; Treatment Failure ; Twins

PURPOSE: The purpose of this study was to identify the effects of abdominal breathing on state anxiety, stress and tocolytic dosage for pregnant women in preterm labor. METHODS: The participants were 60 pregnant women in preterm labor who were hospitalized from April to July, 2009. Thirty participants were assigned to the experimental group and 30 to the control group. None of them had any other complications except preterm labor. The modified Mason's breathing technique was used with the experimental group 3 times a day for 3 days. Data were collected using a self-report questionnaire and chart review, and analyzed with the SPSS 13.0 WIN program. RESULTS: "State anxiety of the experimental group will be lower than that of the control group" was supported. "Stress of the experimental group will be lower than that of the control group" was supported. "The Ritodrine dosage for the experimental group will be lower than that of the control group" was supported. "The Atosiban dosage for the experimental group will be lower than that of the control group" was supported. CONCLUSION: These results indicate that abdominal breathing is an effective nursing intervention for pregnant women in preterm labor.
Adult ; Anxiety/*prevention & control ; *Breathing Exercises ; Female ; Gestational Age ; Humans ; Obstetric Labor, Premature/*drug therapy ; Pregnancy ; Premature Birth ; Ritodrine/therapeutic use ; Stress, Psychological/*prevention & control ; Tocolytic Agents/*therapeutic use ; Vasotocin/analogs & derivatives/therapeutic use

Acute generalized exanthematous pustulosis is a skin reaction characterized by an acute onset, fever, and a cutaneous eruption with non-follicular sterile pustules on edematous erythema. It mimics many of the features of pustular psoriasis but is differentiated by its characteristic clinical course and history. The cause is usually ingested drugs. We report a case of acute generalized exanthematous pustulosis possibly induced by ritodrine
Acute Generalized Exanthematous Pustulosis ; Erythema ; Fever ; Psoriasis ; Ritodrine ; Skin

Ritodrine hydrochloride is widely used for the treatment of premature uterine contraction because the drug has beta2-sympathomimetic effect on the uterus. Hypokalemia is one of the most common side effects of ritodrine. We experienced a case of hyperkalemia without ECG change that occurred during cesarean section in a healthy parturient, associated with low-dose ritodrine pretreatment for six and half hours to stop preterm labor. We treated the patient with potassium-free fluid and calcium chloride. Plasma potassium level returned to normal four hours after the ritodrine had been terminated.
Calcium Chloride ; Cesarean Section ; Electrocardiography ; Female ; Humans ; Hyperkalemia ; Hypokalemia ; Obstetric Labor, Premature ; Plasma ; Potassium ; Pregnancy ; Ritodrine ; Uterine Contraction ; Uterus

We report on two cases of diamniotic dichorionic pregnancy with delayed delivery of the second twin. Case 1 was a 29-year-old woman with a twin pregnancy at 19 weeks and 0 day presenting with a preterm rupture of the membranes (PROM) of the first twin. The patient was treated with ritodrine and systemic broad-spectrum antibiotics. Six hours after admission, the first twin was delivered stillborn without complication. At 23 weeks and 5 days, preterm labor resulted in and the second twin being delivered stillborn at a weight of 564 g. The interval between the first and second delivery was 33 days. Case 2 was a 30-year-old woman with a twin pregnancy at 15 weeks and 4 days presenting with amniotic fluid leakage. PROM was found, and she was treated with ritodrine and systemic broad-spectrum antibiotics. The next day, the first twin was delivered stillborn. At 26 weeks, due to adverse effects, ritodrine was changed to isoxsuprine and magnesium sulfate to control uterine contractions. At 33 weeks and 5 days, onset of labor was observed, and 11 hours after the cessation of treatment with isoxsuprine and magnesium sulfate, a viable female fetus was delivered by spontaneous vaginal delivery, weighing 1,806 g. The mother developed atonic bleeding of the uterus immediately after delivery.;The interval between the first and second twin deliveries was 33 days in case 1 and 127 days in case 2. The longer interval resulted in better fetal outcome, but it also may have increased the risk to the mother.
Twin Multiple Birth ; Delivery ; week ; Ritodrine ; Pregnancy

Ritodrine hydrochloride (Yutopar) is commonly used for the treatment of preterm labor. Published reports claim that many complications of prematurity have been averted by the administration of this drug. However, ritodrine hydrochloride has many side effects, including cardiovascular problem and metabolic error. Only a few reports have described the transient hepatitis (elevated transaminase) all over the world. The clinical significance and incidence of this side effect are still unclear. In this report, we present a case of elevated serum transaminase levels associated with the use of ritodrine during pregnancy with a brief review of the literatures.
Female ; Hepatitis ; Incidence ; Obstetric Labor, Premature ; Pregnancy* ; Ritodrine*

PURPOSE: The purpose of this study was to explore the effects of abdominal breathing on relieving anxiety in women diagnosed with preterm labor. METHOD: This was a pilot study, which was based on a repeated pre-post experiment design without a control group. Seven patients with preterm labor who were admitted to Y university medical center, Seoul, Korea, participated in the experiment. They were under receiving ritodrine hydrochloride(Yutopa) as tocolytic therapy and did not have any other complications. The patients were taught abdominal breathing, which is a modified version of Mason's breathing technique. The experimental treatments were done 33 times from February 18 to June 19 in 2005. RESULT: After abdominal breathing, the average psychological anxiety level decreased significantly. The physical anxiety levels of preterm labor patients were measured by blood pressure, pulse, and skin temperature. After abdominal breathing, the average systolic and diastolic blood pressure decreased from 117.3mmHg to 107.6 mmHg (z=-3.85, p<.001) and from 67.3mmHg to 62.7 mmHg (z=-3.14, p<.005), respectively. The average pulse rate also decreased from 97.2/min to 89.8/mim (z=-4.76, p<.001). The average skin temperature increased from 94.0 to 94.9(z=-4.80. p<.001). CONCLUSION: Abdominal breathing is effective for relieving anxiety of women diagnosed with preterm labor. This study, however, has been limited to short-term effects, and therefore further studies are required in order to examine the long-term effects of abdominal breathing.
Academic Medical Centers ; Anxiety* ; Blood Pressure ; Female ; Heart Rate ; Humans ; Korea ; Obstetric Labor, Premature* ; Pilot Projects ; Pregnancy ; Respiration* ; Ritodrine ; Seoul ; Skin Temperature ; Tocolysis

PURPOSE: This study was conducted to describe the perception of parental sex role held by university students and to examine differences in perception of parental sex role according to student characteristics. METHOD: The participants were 336 university students in Gangreung city. The instrument of parental sex role was developed by the researcher and consisted of 3 subcategories; general parent role, parental sex role as a father and parental sex role as a mother. RESULTS: The most positive item of parental sex role as a father is 'the Father's role is teaching about the value of society'. The most positive item of parental sex role as a mother is 'the Mother's role is to be a counselor or friend'. There were significant differences in perception of a father's role according to sex, type of college, fathers who lived with student during childhood, the relationship with the parent, the plan of marriage and having a child, responsibility of child-rearing, and the need for education for the parental role. There were significant differences in perception of the mother's role according to sex, grade, type of college, birth order, type of family, persons who lived with student during childhood, the relationship with the parent, plan of marriage and having a child, responsibility of child-rearing, and the need for education for the parental role. CONCLUSION: The parental sex role changes overtime. Thus, it is important to identify university student's perception of parental sex roles as pre-parent preparation for parenting.
Birth Order ; Child ; Counseling ; Education ; Fathers ; Gender Identity* ; Humans ; Marriage ; Mothers ; Parenting ; Parents* ; Ritodrine

PURPOSE: This study was conducted to describe the perception of parental role held by university students and to examine difference in perception of parental role according to student characteristics. METHOD: The participant were 338 university student in Gangreung city. The instrument was developed by researcher and consisted of 4 subcategories ; child rearing environment, parental sensitivity, growth and development of infant, and physical care. Data were collected from May 10 to June 1 in 2004 and were analyzed using SPSS Win 10.0 program. RESULT: The university students' perception of total parental role had a mean item score of 4.02, with 4.12 for parental sensitivity, 4.00 for child rearing environment, 4.00 for physical care and 3.95 for growth and development. There were significant differences in perception of parental role according to sex(t=-5.55, p=.00), grade(F=13.12, p=.00), type of college(F=28.34, p=.00), father's age(F=5.01, p=.00), father's education(F=5.01, p=.00), mother's education(F=3.33, p=.03) student's marriage plan(t=2.37, p=.01) main caretaker(F=9.53, p=.00) person who lived with student in childhood(F=3.62, p=.01) and student's perception of the need for education for parental role(t=3.74, p=.00). CONCLUSION: The impact of childhood experience has lifelong significance on subsequent health and development. Especially, the experience of childhood is highly affected by the quality of parental role. It is important to identify university student's perception of parental role as pre-parent preparation for parenting. Therefore, pre-parent education program are necessary.
Child ; Child Rearing ; Education ; Growth and Development ; Humans ; Infant ; Marriage ; Parenting ; Parents* ; Ritodrine ; Child Health

OBJECTIVE: This study was conducted to compare the safety and efficacy of transdermal glyceryl trinitrate (GTN) in initial therapy for preterm labor with those of intravenous ritodrine hydrochloride and the effects of tocolytics in uteroplacental circulation, as assessed by uterine artery doppler velocimetry. METHODS: Patients between 24 and 34 weeks gestation with documented preterm labor were randomly assigned to receive transdermal GTN (n=24) or intravenous ritodrine (n=35) as initial tocolytic therapy. Patients in the GTN group were administered 0.2 mg/h released transdermal patch on the pregnant women's abdomen directly. Patient in the ritodrine group were treated 0.025 mg/min as initial dose. The dose increased at 15 minute intervals until uterine contractions were inhibited or side effects become intolerable. The maximum recommended dose was 0.20 mg/min. The main outcome examined were failure of tocolysis, time to uterine quiescence, time gained in utero, and frequency of adverse effects. We obtained both right and left uterine artery doppler velocity waveform before and after tocolytics therapy. The mean values of the right and left uterine artery systolic and diastolic ratio were calculated and used for analysis. RESULTS: There were no significant difference in maternal demographic between the groups. Successful tocolysis was observed in 79.2% in the GTN group, and 85.7% in the ritodrine group (p=0.726). Time to uterine stop contraction was 5.5 +/- 5.3 hr in ritodrine group and 1.1 +/- 0.3 hr in GTN group. There were no different in time to gain in uterus between the two groups. The patient in the ritodrine group had more adverse side effects, mainly maternal tachycardia (p=0.002), chest pain and tremor (p=0.035). There was no significant difference in uterine S/D ratios between the pretherapy and posttherapy GTN group. However, we found statistically significant difference between the pretherapy and 24 hr-posttherapy in ritodrine group. CONCLUSION: Transdermal GTN was effective, safe, and well tolerable tocolytic agent. Patients who received ritodrine hydrochloride were more likely to have adverse effects. We also conclude that GTN do not affect uteroplacental circulations as measured by S/D ratios but ritodrine does. This results suggest that progressively increasing dose of ritodrin and GTN maybe associated with a statistically significant decrease S/D ratios. However, further investigations needs to be performed.
Abdomen ; Chest Pain ; Female ; Humans ; Nitroglycerin* ; Obstetric Labor, Premature* ; Placental Circulation ; Pregnancy ; Rheology ; Ritodrine* ; Tachycardia ; Tocolysis* ; Tocolytic Agents* ; Transdermal Patch ; Tremor ; Uterine Artery ; Uterine Contraction ; Uterus