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Effects of Ritodrine Hydrochloride on Uterine Activity and the Cardiovascular System in Toxemic Patients

From the Department of Obstetrics and Gynecology, Section of Perinatal Biology of the Los Angeles County-University of Southern California Medical Center

Abstract

The effects of ritodrine hydrochloride were evaluated in 25 toxemic patients in active labor utilizing continuous electronic monitoring of fetal and maternal cardiovascular systems and uterine activity. Fetal scalp blood and free flowing maternal antecubital venous blood was obtained for pH, Po₂, Pco₂, base deficit and blood glucose determinations prior to and immediately following the study period. The initial ritodrine dose was 50 µg/min for 15 minutes. The dose was increased by 50 µg/min each 15 minutes until there was a clinically apparent reduction in uterine activity. Once this was accomplished, the infusion was maintained for 30 minutes. There was a consistent increase in the maternal heart rate (MHR) and a significant rise in fetal heart rate (FHR) late in the infusion and in the postinfusion period. There was a widening of the maternal pulse pressure mainly due to a reduction in diastolic pressure with little change in the mean blood pressure. Maternal and fetal pH decreased and base deficit increased during the study although the Po₂ and Pco₂ remained unchanged. Maternal and fetal blood glucose rose significantly following ritodrine infusion.