Clinical obstetrics and gynecology
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Pregnancy increases the risk for respiratory failure from to numerous pulmonary diseases. Adult respiratory distress syndrome, aspiration, venous air embolism, asthma, thromboembolism, and heart disease are etiologies shared by non-pregnant women. ⋯ Diagnostics and supportive care is difficult and must be directed with the mother and the fetus in mind. This dictates a thorough understanding of maternal physiology, and the safety of drug use during pregnancy.
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The role of oxytocin and oxytocin receptors in preterm labor is perhaps more prominent than once thought. The blockade of oxytocin and/or oxytocin receptors has both a theoretical and clinical aspect. Initial trials with the oxytocin antagonist atosiban have been encouraging with respect to efficacy and side effect profile. ⋯ Additional work must be done with this drug. However, if subsequent data demonstrate that atosiban is as effective as ritodrine in obtaining uterine quiescence, on the basis of its milder side effect profile, it should be seriously considered as a tocolytic of choice for the treatment of preterm labor. Moreover, it may have significant appeal for combination use with other tocolytics, given its alternative mechanism of action to betamimetics and magnesium sulfate.