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Ritodrine and isoxsuprine in management of preterm labor.

INTRODUCTION
Preterm delivery is an important cause of perinatal morbidity and mortality. To decrease the medical and economical impact of preterm delivery, tocolytic agents are available among which isoxsuprine and ritodrine are widely used in Nepal. The study on efficacy of ritodrine and isosuprine has not been done yet in Nepelese women. So to observe on efficacy and safety of Ritodrine and Isoxsuprine, this study was conducted.


METHODS
A prospective observational study was conducted with an aim to assess the efficacy and safety of Isoxsuprine 10 mg orally eight hourly versus Ritodrine 10 mg initially infused intravenously along with 5% dextrose at the rate of 10 drops per minute with an increase of 5-10 drops every 30 minutes for 24 hours and then given oral at 5-10 mg eight hourly, in patient with preterm labor requiring uterine tocolysis.


RESULTS
This study found that Ritodrine is more effective and safer than Isoxsuprine in suppressing preterm labor. The failure rate of Isoxsuprine and Ritodrine were 22.22% and 6.5% respectively. The maternal side effects including cardiac side effects were significantly higher in Isoxsuprine. The cardiac side effects caused by Ritodrine can be controlled by adjusting the drip rate. Though Isoxsuprine seems more economical than Ritodrine, it is lesser cost effective to patients due to its higher failure rate, that results in added expenses in terms of increased morbidity and mortality.


CONCLUSIONS
Hence, Ritodrine is superior to Isoxsuprine as it is more efficacious in managing preterm labor and increasing fetal maturity. Also the adverse effects of Ritodrine are less than those of Isoxsuprine which result in better patient compliance and cost effectiveness.