Ritodrine in the management of fetal distress.

The potential value of a bolus injection of ritodrine in the management of fetal distress was examined in 24 patients. Following the injection of ritodrine, uterine activity measured over a period of 14.7 +/- 6.3 (SD) min was reduced to 22 (+/- 12.4 SD)% of the pre-existing values. The cardiotocographic tracings showed a reversion to a normal or less ominous pattern in 14 of the 16 patients where this could be evaluated. The infants in the ritodrine group took less time to establish regular respirations. The perinatal neurobehaviour in the ritodrine and control groups did not differ. Two mothers who were given ritodrine and who received atropine premedication developed tachycardia and marked systolic hypertension. The administration of a bolus of ritodrine may have a place in the management of fetal distress when caesarean section is unavoidably delayed, but atropine premedication must be avoided as the combination can lead to potentially serious cardiovascular complications.