The effect of the oxytocin antagonist atosiban on preterm uterine activity in the human

• Published in: American journal of obstetrics and gynecology Vol. 170; no. 2; pp. 474 - 478
• Main Authors: Goodwin, T.Murphy, Paul, Richard, Silver, Helayne, Spellacy, William, Parsons, Michael, Chez, Ronald, Hayashi, Robert, Valenzuela, Guillermo, Creasy, George W., Merriman, Rosanne
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01.02.1994; Elsevier
• Subjects: Adult; Bed Rest; Biological and medical sciences; Delivery. Postpartum. Lactation; Double-Blind Method; Female; Fluid Therapy; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Obstetric Labor, Premature - drug therapy; Obstetric Labor, Premature - therapy; Obstetrical techniques; Oxytocin - antagonists & inhibitors; oxytocin antagonist; Pregnancy; Pregnancy Outcome; Preterm labor; Tocolytic Agents - adverse effects; Tocolytic Agents - pharmacology; Tocolytic Agents - therapeutic use; uterine contractility; Uterine Contraction - drug effects; Vasotocin - adverse effects; Vasotocin - analogs & derivatives; Vasotocin - pharmacology; Vasotocin - therapeutic use; Preterm labor; oxytocin antagonist; uterine contractility; Human; Chemotherapy; Treatment; Pregnancy disorders; Oxytocin; Uterus; Perfusion; Threatened premature delivery; Antagonist; Biological effect; Contraction
• ISSN: 0002-9378; 1097-6868
• DOI: 10.1016/S0002-9378(94)70214-4

OBJECTIVE: The purpose of this study was to test the hypothesis that infusion of the oxytocin antagonist atosiban results in decreased preterm uterine activity in the human. STUDY DESIGN: A randomized, double-blind, placebo-controlled trial was performed. One hundred twenty women from 20 to 36 weeks' gestation with a complaint of labor who had more than four uterine contractions per hour after intravenous hydration but no evidence of cervical change were randomized to receive a 2-hour intravenous infusion of atosiban at a rate of 300 μg/min or placebo. One hundred-twelve subjects (56 in each arm) were suitable for analysis of efficacy. Both groups remained at bed rest and received hydration. RESULTS: The mean percent decrease in contraction frequency was greater in atosiban subjects compared with controls (55.3% ± 36.3% vs 26.7% ± 40.4%, mean ± SD, p < 0.001). A minimal (< 20%) decrease or an increase in contraction frequency was noted in 25 placebo subjects (45%) and seven atosiban subjects (13%). There was no clinically or statistically significant change in maternal blood pressure or heart rate during the infusion. The only adverse experiences possibly related to the drug were nausea and vomiting in one atosiban patient. CONCLUSION: A 2-hour infusion of the oxytocin antagonist atosiban resulted in a significantly greater decline in contraction frequency compared with controls. Oxytocin appears to play a role in the maintenance of preterm uterine activity in the human. (AM J OBSTET GYNECOL 1994;170:474-8.)