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  • Original Article

    Transdermal nitroglycerin versus oral nifedipine administration for tocolysis: a randomized clinical trial

    Rev Bras Ginecol Obstet. 2009;31(11):552-558

    Summary

    Original Article

    Transdermal nitroglycerin versus oral nifedipine administration for tocolysis: a randomized clinical trial

    Rev Bras Ginecol Obstet. 2009;31(11):552-558

    DOI 10.1590/S0100-72032009001100005

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    PURPOSE: to compare the effectiveness of transdermal nitroglycerin with oral nifedipine in the inhibition of preterm delivery. METHODS: a clinical essay has been performed with 50 women in preterm delivery, randomly divided into two groups, 24 receiving oral nifedipine (20 mg), and 26, transdermal nitroglycerin (10 mg patch). Patients with a single gestation, between the 24th and the 34th weeks and diagnosis of preterm delivery were selected. Women with fetal malformation and clinical or obstetric diseases were excluded. The variables analyzed were: effective tocolysis, time needed for tocolysis, recurrence frequency, progression to preterm delivery, and side effects. RESULTS: tocolysis efficacy in the first 12 hours was similar between the groups (nitroglycerin: 84.6% versus nifedipine: 87.5%; p=0.50). The time average time needed for tocolysis was also similar (6.6 versus 5.8 hours; p=0.30). There was no difference between the groups, concerning the recurrence of preterm delivery (26.9 versus 16.7%; p=0.30), and neither in the rate of preterm delivery within 48 hours (15.4 versus 12.5%; p=0.50). Nevertheless, the cephalea rate was significantly higher in the Nitroglycerin Group (30.8 versus 8.3%; p=0.04). CONCLUSIONS: transdermal nitroglycerin has presented similar effectiveness to oral nifedipine to inhibit preterm delivery in the first 48 hours, however with higher cephalea frequency.

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    Transdermal nitroglycerin versus oral nifedipine administration for tocolysis: a randomized clinical trial
  • Original Article

    Route of delivery in successive gestations in adolescents: study of 714 cases

    Rev Bras Ginecol Obstet. 2004;26(9):703-707

    Summary

    Original Article

    Route of delivery in successive gestations in adolescents: study of 714 cases

    Rev Bras Ginecol Obstet. 2004;26(9):703-707

    DOI 10.1590/S0100-72032004000900005

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    PURPOSE: to analyze the association between modes of consecutive deliveries of 714 adolescents attended at the Maternity sector of the Hospital das Clínicas da Universidade Federal de Pernambuco (Federal University of Pernambuco), from January to December 2001. PATIENTS AND METHODS: according to a prospective, analytic, transversal, and incidence type study, the sequence of delivery modes was analyzed from the first to the fourth parturition of 714 pregnant adolescents, aged from 13 to 19 years (mean17.2±1.5 years). Every day, after identifying the adolescents who delivered, by the parturition room register, they were invited to participate in this study. Those who agreed, after signing a free informed consent answered a structured questionnaire with 65 direct questions with precodified closed options, among which were delivery mode and number of gestations. RESULTS: it was found that 527 (73.8%) adolescents had only one delivery, 149 (20.9%) two deliveries, 35 (4.9%) three deliveries, and 3 (0.4%) had had four deliveries. Among the 273 cesarean sections, 207 (75.8%) occurred in primiparae, 65 (23.8%) in secundiparae and one (0.4%) in a multipara. There was a statistically significant association between the first and the second deliveries for 83 (55.7%) adolescents who had transvaginal delivery, as well as for 41 (27.5%) by cesarean section. There was also coincidence about the second and third deliveries, regarding transvaginal delivery of 23 (65.7%) adolescents, as well as cesarean section of 10 (28.6%) adolescents. CONCLUSION: a tendency to coincidence of subsequent delivery modes was identified for adolescents until the third parturition.

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