A loading model for ritodrine administration in preterm labour

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Abstract
Objective To develop a ritodrine infusion scheme for preterm labour that avoids plasma levels above those needed for tocolysis, requires only one rate adjustment, and is easy to apply in practice.Design Prospective study of tocolytic effect and plasma ritodrine concentrations during application of the infusion scheme.Setting High risk labour ward.Subjects Consecutive series of 31 women in labour at less than 36 weeks' gestation.Intervention Loading dose ritodrine infusion followed, as soon as tocolysis is reached, by a decrease in the infusion rate calculated on the basis of the interval between start of treatment and tocolysis.Results Overall, steady state ritodrine levels were nearly identical to those at the time of tocolysis and correlated well with levels anticipated on the basis of our calculation (n= 30; r= 0.91; P Conclusion The loading model is easy to apply, avoids relative overdoses, requires few adjustments, is well tolerated, uses smaller quantities of ritodrine, and results in lower plasma ritodrine concentrations than the conventional infusion scheme.

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