Abstract
Purpose
To determine whether the use of uterotonics, including oxytocin and prostaglandins, increases the risk of abruptio placentae and eclampsia.
Materials and methods
A retrospective analysis was conducted among 260,174 Japanese women at term. Demographic characteristics were studied as possible candidates for risk factors of abruptio placentae and eclampsia using multivariate logistic regression analyses.
Results
A total of 1,058 (0.41 %) and 147 (0.06 %) women developed abruptio placentae and eclampsia, respectively. Abruptio placentae and eclampsia occurred in 177 (0.29 %) and 42 (0.07 %) of the 61,857 women treated with uterotonics, respectively. Multivariate regression analyses indicated that uterotonics did not increase risk of developing either abruptio placentae or eclampsia. Primiparity [odds ratio (95 % confidence interval) 1.41 (1.24–1.60)], age ≥35 years [1.17 (1.03–1.33)], and presence of hypertension [2.42 (1.93–3.03)] were significant independent risk factors for abruptio placentae, while advancing gestation [0.67 (0.63–0.71)] decreased risk of abruptio placentae. Primiparity [odds ratio (95 % confidence interval) 4.06 (2.49–6.63)], age <20 years [2.44 (1.07–5.58)], presence of hypertension [28.7 (20.5–40.1)], and advancing gestation [1.28 (1.11–1.47)] were significant independent risk factors for eclampsia.
Conclusion
The use of uterotonics did not increase the risk of abruptio placentae and eclampsia.
Similar content being viewed by others
References
Pharmaceutical and Food Safety Bureau, Japanese Ministry of Labour, Health and Welfare (2010) Concerning revision of package insert (file number 0601-1)
Knight M, Tuffnell D, Brocklehurst P, Spark P, Kurinczuk JJ, UK Obstetric Surveillance System (2010) Incidence and risk factors for amniotic-fluid embolism. Obstet Gynecol 115:910–917
Roberts CL, Algert CS, Knight M, Morris JM (2010) Amniotic fluid embolism in an Australian population-based cohort. BJOG 117:1417–1421
Knight M, Berg C, Brocklehurst P, Kramer M, Lewis G, Oats J, Roberts CL, Spong C, Sullivan E, van Roosmalen J, Zwart J (2012) Amniotic fluid embolism incidence, risk factors and outcomes: a review and recommendations. BMC Pregnancy Childbirth. doi:10.1186/1471-2393-12-7
Yamada T, Yamada T, Morikawa M, Takeda M, Akaishi R, Nishida R, Araki N, Koyama T, Minakami H (2011) Do uterotrophic drugs increase the risk of fatal hemorrhagic brain stroke? J Perinat Med 39:23–26
Fontenot MT, Lewis DF, Barton CB, Jones EM, Moore JA, Evans AT (2005) Abruptio placentae associated with misoprostol use in women with preeclampsia. J Reprod Med 50:653–658
Martinez de Tejada B, Martillotti G, Lapaire O, Hoesli I, Irion O (2010) The risk of placental abruption when using prostaglandins for cervical ripening in women with preeclampsia: comparing misoprostol versus dinoprostone. J Matern Fetal Neonatal Med 23:988–993
Minakami H, Hiramatsu Y, Koresawa M et al (2011) Guidelines for obstetrical practice in Japan: Japan Society of Obstetrics and Gynecology (JSOG) and Japan Association of Obstetricians and Gynecologists (JAOG) 2011 edition. J Obstet Gynaecol Res 37:1174–1197
Morikawa M, Cho K, Yamada T, Yamada T, Sato S, Minakami H (2012) Risk factors for eclampsia in Japan between 2005 and 2009. Int J Gynaecol Obstet 117:66–68
Matsuda Y, Hayashi K, Shiozaki A, Kawamichi Y, Sato S, Saito S (2011) Comparison of risk factors for placental abruption and placenta previa: case–cohort study. J Obstet Gynaecol Res 37:538–556
Koopmans CM, Bijlenga D, Groen H, Vijgen SM, Aarnoudse JG, Bekedam DJ, van den Berg PP, de Boer K, Burggraaff JM, Bloemenkamp KW, Drogtrop AP, Franx A, de Groot CJ, Huisjes AJ, Kwee A, van Loon AJ, Lub A, Papatsonis DN, van der Post JA, Roumen FJ, Scheepers HC, Willekes C, Mol BW, van Pampus MG; HYPITAT study group (2009) Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks’ gestation (HYPITAT): a multicentre, open-label randomised controlled trial. Lancet 374:979–988
Minakami H, Kubo T, Takeda S, Kawabata M, Kobayashi T, Nakabayashi M (2009) Placental abruption, HELLP syndrome, and eclampsia in Japan. Nippon Sanka-Fujinka Gakkai Zasshi 61:1559–1567 (in Japanese)
Sheiner E, Shoham-Vardi I, Hadar A, Hallak M, Hackmon R, Mazor M (2002) Incidence, obstetric risk factors and pregnancy outcome of preterm placental abruption: a retrospective analysis. J Matern Fetal Neonatal Med 11:34–39
Sheiner E, Shoham-Vardi I, Hallak M, Hadar A, Gortzak-Uzan L, Katz M, Mazor M (2003) Placental abruption in term pregnancies: clinical significance and obstetric risk factors. J Matern Fetal Neonatal Med 13:45–49
Kullberg G, Lindeberg S, Hanson U (2002) Eclampsia in Sweden. Hypertens Pregnancy 21:13–21
Douglas KA, Redman CWG (1994) Eclampsia in the United Kingdom. BMJ 309:1395–1400
Knight M; UKOSS (2007) Eclampsia in the United Kingdom 2005. BJOG 114:1072–1078
van der Tuuk K, Koopmans C, Groen H, Mol BW, van Pampus MG; HYPITAT study group (2011) Impact of the HYPITAT trial on doctors’ behaviour and prevalence of eclampsia in the Netherlands. BJOG 118:1658–1660
Jozwiak M, Oude Rengerink K, Benthem M, van Beek E, Dijksterhuis MG, de Graaf IM, van Huizen ME, Oudijk MA, Papatsonis DN, Perquin DA, Porath M, van der Post JA, Rijnders RJ, Scheepers HC, Spaanderman ME, van Pampus MG, de Leeuw JW, Mol BW, Bloemenkamp KW; PROBAAT Study Group (2011) Foley catheter versus vaginal prostaglandin E2 gel for induction of labour at term (PROBAAT trial): an open-label, randomised controlled trial. Lancet 378:2095–2103
Conflict of interest
All the authors declare that they have no financial relationships with a biotechnology manufacturer, pharmaceutical company, or other commercial entity that has an interest in the subject matter or the materials discussed in the manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Morikawa, M., Cho, K., Yamada, T. et al. Do uterotonic drugs increase risk of abruptio placentae and eclampsia?. Arch Gynecol Obstet 289, 987–991 (2014). https://doi.org/10.1007/s00404-013-3101-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-013-3101-8