Uterine relaxation

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Uterine relaxation

  1. 1. UTERINE RELAXANTS
  2. 2. These are the drugs which decrease uterine motility. USES: Delay or postpone labour. Arrest abortion Dysmenorrhoea Suppression of labour allowed foetus to mature. Premature labour is done only if cervical dilation is < 4 cm
  3. 3. Contraindications: <ul><li>Rupturing of membrane </li></ul><ul><li>Antepartum haemorrhage occur </li></ul><ul><li>In severe toxaemia of pregnancy </li></ul><ul><li>Intrauterine infection </li></ul>
  4. 4. CLASSIFICATION <ul><li>Adrenergic agonist Ritodrine </li></ul><ul><li>Calcium channel blocker Nifedipine </li></ul><ul><li>Magnesium sulfate </li></ul><ul><li>Oxytocin antagonist Atosiban </li></ul><ul><li>Miscellaneous Ethyl alcohol, </li></ul><ul><li>nitrates, halothane </li></ul>
  5. 5. Adrenergic agonist <ul><li>β 2 selective agonist. </li></ul><ul><li>Suppress premature labour and delay delivery in exigency </li></ul><ul><li>DOSE: 50µg/min. i.v. infusion, increased with every 10 min. Ceases uterine contraction or materal HR rises to 120/min. </li></ul><ul><li>10 mg i.m. 4-6 hourly followed by 10 mg oral </li></ul><ul><li>delivery postponed </li></ul>
  6. 6. Side effects: Cardiovascular, metabolic complication, anxiety, restlessness, headache. NOT USED : Diabetic, heart disease, steroids or β blockers. <ul><li>2 ) Calcium channel blockers </li></ul><ul><li>Reduce the tone of myometrium and oppose contraction. </li></ul><ul><li>Having smooth muscle relaxant action </li></ul><ul><li>Postponed labour </li></ul>
  7. 7. DOSE : 10 mg oral every 20- 30 min. till contraction ceases followed by 10 mg 6 hourly. Side effects: Tachycardia and hypotension 3) Magnesium sulfate : Control convulsions and reduce BP in toxaemia of pregnancy. Drug of choice : prevention and t/t of seizure in preclampsia and eclampsia
  8. 8. <ul><li>4 ) Oxytocin antagonist: </li></ul><ul><li>Peptide analogue of oxytocin act as antagonist at receptor </li></ul><ul><li>Suppress premature uterine contraction and postpone preterm delievery. </li></ul> DOSE: i.v. bolus (2- 4 gm over10 - 20 min.) followed by 1 gm/hr i.v. infusion. Toxicity induce cardiac arrhythmia, paralysis, CNS and respiratory depression in mother and neonates .
  9. 9. 5) Miscellaneous drugs <ul><li>Ethyl alcohol, nitrates, progesterone, PG’s synthesis inhibitors can depress uterine contraction. </li></ul><ul><li>Not dependable. </li></ul><ul><li>Progesterone has been found to prevent miscarriage in some high risk cases . </li></ul>

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