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Nitroglycerin patch improves preterm neonatal outcomes: results seen despite no delay in delivery.(NEWS)
TORONTO -- Transdermal nitroglycerin improved neonatal outcomes but didn't significantly delay time to delivery, according to results of the Canadian Preterm Labor Nitroglycerin Trial.
"Given that there is no standard of care [for the management of preterm labor] and that no tocolytic has been shown to improve outcome, this is potentially very exciting," remarked principal investigator Dr. Graeme N. Smith of Queen's University in Kingston, Ontario. His center and several others have already adopted this approach as standard, he said in an interview.
The study, which he presented at the annual meeting of the Society for Gynecologic Investigation, randomized 158 women between 24 and 32 weeks' gestation and in preterm labor to either placebo (n = 81) or a transdermal nitroglycerin, or glyceryl trinitrate (GTN), patch (n = 77).
The primary outcome measured was a neonatal morbidity composite that included one or more of the following: chronic lung disease, necrotizing enterocolitis (NEC), intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), and perinatal mortality. The secondary outcome was the time to delivery.
Upon entry into the study and before randomization, all the women received a 500- mL saline bolus (0.9%) to offset the potentially dehydrating effects of GTN, according to Dr. Smith. The GTN patch delivered a ...
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