Asymmetric septal hypertrophy in infants exposed to ritodrine in utero

Objective & Hypothesis:AIM: Beta-2 sympathomimetic drug, ritodrine which has been used for inhibition of preterm labor was proved to cause ventricular septal hypertrophy.

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Key Findings & Data:MATERIAL AND METHODS: We obtained echocardiograms from infants exposed to ritodrine, from 24 of them on the first day of life, from 16 of them on the 4th week, from 9 of them on the 10th week, and also from 18 control infants matched for gestational age.

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Conclusion & Impact:Therefore, we think that maternal ritodrine use should be considered among the causes of ASH.

🔬Design:Research Article

📍Scope:Comprehensive Sample

⚙️Variables:Ekokardiyografi · Prenatal maruziyetin geç etkileri · Süt çocuğu

Abstract

AIM: Beta-2 sympathomimetic drug, ritodrine which has been used for inhibition of preterm labor was proved to cause ventricular septal hypertrophy. The aim of the study was to determine whether newborn infants exposed in utero to tocolytic therapy with ritodrine showed echocardiographic changes. MATERIAL AND METHODS: We obtained echocardiograms from infants exposed to ritodrine, from 24 of them on the first day of life, from 16 of them on the 4th week, from 9 of them on the 10th week, and also from 18 control infants matched for gestational age. RESULTS: Mean duration of ritodrine exposure was 27.8+30 days (range 1-98 days). Infants in study group had increased IVSd and increased IVSd/LVPWd ratio compared with control values (4.09±1.23mm, 2,97±0.55mm and p<0.03; 1.37±0.28, 1.03±0.20 and p<0.01, respectively). There were no correlation between IVSd, LVPWd and IVSd/LVPWd ratio, and the duration of ritodrine exposure (r=0.295, r=0,148, r=0,047; p>0,05 respectively). However, IVSd/LVPWd ratio was greater than 1.3 in 83.3% of infants exposed to ritodrine for 2 weeks or longer and in 50% of infants exposed for less than 2 weeks (p<0.05). IVSd/LVPWd ratio returned to normal in all infants within 10 weeks, CONCLUSION: These data show that newborn infants exposed to ritodrine for longer than 2 weeks may present with asymmetric septal hypertrophy. Therefore, we think that maternal ritodrine use should be considered among the causes of ASH.

Özet

AMAÇ: Asimetrik septal hipertrofi (ASH), interventriküler septum kalınlığının sol ventrikül posterior duvar kalınlığına oranının (IVSd/LVPWd) 1.3'den büyük olması olarak tanımlanır. Prematür doğumları önlemek için kullanılan beta-2 sempatomimetik ajan ritodrinin asimetrik septal hipertrofiye neden olduğu bildirilmiştir. Ritodrinin bu etkisini araştırmak için bu çalışma planlandı. GEREÇ VE YÖNTEM: İnutero ritodrine maruz kalan 24 ve gestasyon yaşları uyumlu 18 yenidoğan infant, yaşamlarının 1. gününde ekokardiyografık olarak değerlendirildi. Çalışma grubundaki 16 yenidoğana 4. cü haftada, 9 yenidoğana ise 4 ve 10. haftalarda ekokardiyografi tekrarlandı. BULGULAR: Ortalama ritodrine maruz kalınan süre 27.8±30 gündü (1-98 gün). Çalışma grubunda İVSd ve İVSd/LVPWd oranı kontrol grubuna göre artmış olarak saptandı (sırasıyla: 4.09±1.23mm, 2.97±0.55mm ve p 0,05 ). Bununla birlikte 2 haftadan uzun süre ritodrine maruz kalan infantların %83.3'ünde, 2 haftadan kısa süre ritodrine maruz kalan infantların ise %50'sinde IVSd/LVPWd oranı 1.3'den fazla bulundu (p<0.05).Tüm infantların 10 haftalık izlemlerinde IVSd/L VPWd oranının normale döndüğü görüldü. SONUÇ: Bu çalışma nedeniyle; asimetrik septal hipertrofi nedenleri arasında annede ritodrine kullanımının hatırlanmasını ve 2 haftadan uzun süre ritodrine maruz kalan yenidoğanların ekokardiyografik olarak değerlendirilmesinin uygun olacağını düşünmekteyiz.

Keywords

Ekokardiyografi Prenatal maruziyetin geç etkileri Süt çocuğu yenidoğan Gebelik yaşı Ritodrin Kardiyomiyopati hipertrofik Echocardiography Prenatal Exposure Delayed Effects Infant Newborn Gestational Age Ritodrine Cardiomyopathy Hypertrophic

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Cite This Article

ÖCAL, B., AYDIN, Ö. F., OĞUZ, D., ARSAN, S., KARADEMİR, S. (2000). Asymmetric septal hypertrophy in infants exposed to ritodrine in utero. MN Kardiyoloji, Cilt: 7 - Sayı: 6, 454–456. https://ajindex.com/articles/298102

References (1)

Nuchpuckdee P, Brodsky N, Porat R, Hurt H. Ventricular septal thickness and cardiac function in neonates after in utero ritodrine exposure. J Pediatr 1986; 109(4):687. Maron BJ, Clark CE, Henry WL, et al. Prevalence and characteristics of disproportionate ventricular septal thickening in patients with aquired or congenital heart disease. Circulation 1977; 55:489. Cecchi F, Zuppiroli A, Manetti A. Transient asymmetric ventricular septal hypertrophy in newborn unassociated with maternal diabetes. Br Heart J 1984; 52:228. Manetti A, De Simone L, Pollini I, Favilli S, Scarano E, Donzelli GP. Transient ventricular septal hypertrophy in the first year of life associated with neonatal brain injury. Pediatr Cardiol 1992; 13(1):63. Breitweser JA, Meyer RA, Sperling MA, et al. Cardiac septal hypertrophy in hyperinsulinemic infants. J Pediatr 1980; 96:535. Procianoy RS, Pinheiro CEA 1982. Neonatal hyperinsulinemia after short-term maternal beta sympathomimetic therapy. J Pediatr 1982; 101:612. Carter BS, DiGiacomo JE, Balderston SM, Wiggins JW, Merenstein GB. Disproportionate septal hypertrophy associated with erythroblastosis fetalis. AJDC 1990; 144:1225. Edoute Y, Blumenfeld Z, Bronstein M, Aharoni L, Moskowitz M. Peripartum congestive cardiomyopathy and endocardial fibroelastosis associated with ritodrine treatment. J of Rep Med 1987; 32(10):793. Benedetti TJ. Maternal complications of parenteral betasympathomimetic therapy for premature labor. Am J Obstet Gynecol 1983; 145:1. Juha R. The effects of ritodrine infusion on fetal myocardial function and fetal hemodynamics. Acta Obstet Gynecol Scand 1990; 69:487. Procianoy RS, Cecin SKG. High insulin cord levels in LGA infants born to non-diabetic, non-obese mothers. Pediatr Res 1989; 25:228. Epstein MF, Nicholis E, Stubblefield PG. Neonatal hypoglicemia after betasympathomimetic tocolytic therapy. J Pediatr 1979; 94:449. Lauersen NH, Merkatz İR, Tejani N, et al. Inhibition of premature labor: a multicenter comparison of ritodrine and ethanol. Am J Obstet Gynecol 1997; 127:837. Perloff JK. Pathogenesis of hypertrophic cardiomyopathy: Hypotheses and speculations. Am Heart J 1981; 101:219.