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Obstetrics & Gynecology 1983;61:S10-S11
© 1983 by The American College of Obstetricians and Gynecologists
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Unexpected Cardiac Pathology In Pregnant Women Treated With Beta-Adrenergic Agents (Ritodrine)

RAPHAEL RON-EL, MD, ELIAHU CASPI, MD, ARIEH HERMAN, MD, PETER SCHREYER, MD, MOSHE ALGOM, MD and ZVI SCHLEZINGER, MD

From the Department of Obstetrics and Gynecology and The Heart Institute, Assaf Harofeh Hospital, Affiliated to Sackler School of Medicine, Tel-Aviv University, Zerifin, Israel

Abstract

Premature uterine contractions were treated by intravenous ß-mimetics in 190 patients during a 2-year period. History and physical examination were directed toward identification of patients with cardiac problems. Unexpected cardiac pathology was discovered in 4 patients, all of whom exhibited severe and continuous nausea, retrosternal pain, or dyspnea during ß-mimetic administration. Treatment was immediately discontinued in the presence of S-T depression, supraventricular tachycardia, nonspecific T wave changes, and sinus tachycardia with right axis deviation. Further investigation revealed obstructive cardiac myopathy in one case and atrial septal defect in another. Such changes might be identified earlier by more extensive screening procedures (such as electrocardiogram) before drug administration. Administration of ßmimetic agents may uncover previously unexpected cardiac pathology. Continuation of ritodrine in such cases is contraindicated and potentially hazardous. (Obstct Gynecol 61:10S, 1983)






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