Bone ultrasonometry measurements during pregnancy

Abstract Purpose During pregnancy we can have changes of the calcium metabolism that can determine a loss of bone mass. Some studies used single-photon absorptiometry (SPA) or dual-energy X-ray absorptiometry, but these exams are inadvisable in pregnancy for the teratogenic eVects on the fetus. We used quantitative ultrasonometry (QUS). The aim of this study is to determine prospective changes of bone density with an ultrasonometry measurement during pregnancy in healthy Italian women. Methods The study population was represented by 59 pregnant women. Quantitative ultrasonometry measurements were performed at the phalanges during the Wrst, second and third trimester. Results We found a progressive decrease of bone time transmission (BTT) from the Wrst to the third trimester, while amplitude dependent speed of sound (AD-SoS) remained stable between the Wrst and the second trimester and decreased at the term of pregnancy. The z- and t-scores decreased more during the second and third trimester. Conclusions These results show an important reduction in the third trimester of pregnancy, of all ultrasonometry variables and then an increase of remodelling with bone demineralisation in the mother. These results show that there is a diVerent bone metabolism in pregnancy in pluriparous and nulliparous women

Therapy side-effects and predictive factors for preterm delivery in patients undergoing tocolysis with atosiban or ritodrine for threatened preterm labour

The objective of this study was to compare the safety and efficacy of atosiban and ritodrine in the treatment of threatened preterm labour (TPL) and to analyse the predictive factors of preterm delivery. We retrospectively sampled data on 380 women hospitalised for TPL (24-35 weeks' gestation), in our clinic between 2004 and 2007. All were subjected to tocolysis with ritodrine and/or atosiban. Data were analysed using R (version 2.12.1), considering p < 0.05 as significant. We had 69 women treated with atosiban, 242 treated with ritodrine and 69 treated with ritodrine changed for atosiban, if adverse effects occurred. In the multivariate logistic regression, the use of atosiban vs ritodrine does not play any role in delaying delivery after 48 h or 7 days, whereas the cervical change at the digital examination, high contractions pre/post-therapy ratio, pPROM, cervical length and fibronectin result as predictive factors for both delivery before 48 h or 7 days. Maternal adverse drug effects were significantly more frequent in patients treated with ritodrine, and one single case of pulmonary oedema was observed. We found fewer side-effects in the atosiban than in the ritodrine group and no difference in efficacy. Moreover, the most predictive factors for preterm delivery were fibronectin test, pPROM, digital vaginal examination and uterine contraction persistence. We believe that predictive capacity of these tests could give the opportunity for targeting therapy and limiting drug side-effects and cost

Therapy side-effects and predictive factors for preterm delivery in patients undergoing tocolysis with atosiban or ritodrine for threatened preterm labour.

The objective of this study was to compare the safety and effi cacy of atosiban and ritodrine in the treatment of threatened preterm labour (TPL) and to analyse the predictive factors of preterm delivery. We retrospectively sampled data on 380 women hospitalised for TPL (24 \u2013 35 weeks \u2019 gestation), in our clinic between 2004 and 2007. All were subjected to tocolysis with ritodrine and/or atosiban. Data were analysed using R (version 2.12.1), considering p 0.05 as signifi cant. We had 69 women treated with atosiban, 242 treated with ritodrine and 69 treated with ritodrine changed for atosiban, if adverse eff ects occurred. In the multivariate logistic regression, the use of atosiban vs ritodrine does not play any role in delaying delivery after 48 h or 7 days, whereas the cervical change at the digital examination, high contractions pre/post-therapy ratio, pPROM, cervical length and fi bronectin result as predictive factors for both delivery before 48 h or 7 days. Maternal adverse drug eff ects were signifi cantly more frequent in patients treated with ritodrine, and one single case of pulmonary oedema was observed. We found fewer side-eff ects in the atosiban than in the ritodrine group and no diff erence in effi cacy. Moreover, the most predictive factors for preterm delivery were fi bronectin test, pPROM, digital vaginal examination and uterine contraction persistence. We believe that predictive capacity of these tests could give the opportunity for targeting therapy and limiting drug side-eff ects and cost