{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T17:36:46Z","timestamp":1789839406260,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>In Japan, unlike Western countries, tocolytic agents are administered in long\u2010term protocols to treat threatened preterm labor. Evaluating the side effects of this practice is crucial. We examined whether ritodrine hydrochloride had been administered in cases of maternal death, aiming to investigate any relationship between ritodrine administration and maternal death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study used reports of maternal deaths from multiple institutions in Japan between 2010 and 2020. Data on the reported cases were retrospectively analyzed, and data on the route of administration, administered dose, and clinical findings, including causes of maternal death, were extracted. The amount of tocolytic agents was compared between maternal deaths with ritodrine administration and those without.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 390 maternal deaths were reported to the Maternal Death Exploratory Committee in Japan during the study period. Ritodrine hydrochloride was administered in 32 of these cases. The frequencies (\n                      <jats:italic>n<\/jats:italic>\n                      ) and median doses (range) of oral or intravenous ritodrine hydrochloride were 34.4% (11) and 945 (5\u20132100) mg and 84.4% (27) and 4032 (50\u201318\u2009680) mg, respectively. Frequencies of perinatal cardiomyopathy, cerebral hemorrhage, diabetic ketoacidosis, and pulmonary edema as causes of maternal death were significantly higher with ritodrine administration than without it.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our results suggest a relationship between long\u2010term administration of ritodrine hydrochloride and an increased risk of maternal death due to perinatal cardiomyopathy, cerebral hemorrhage, diabetic ketoacidosis, and pulmonary edema. In cases where ritodrine should be administered to prevent preterm labor, careful management and monitoring of maternal symptoms are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jog.15951","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T23:59:17Z","timestamp":1713311957000},"page":"1111-1117","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Relationship between maternal mortality and ritodrine hydrochloride as a tocolytic agent in Japan"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2420-203X","authenticated-orcid":false,"given":"Masamitsu","family":"Nakamura","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology Fujita Health University  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiko","family":"Sekizawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Showa University School of Medicine  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5789-1022","authenticated-orcid":false,"given":"Junichi","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology St. Marianna School of Medicine  Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3621-1251","authenticated-orcid":false,"given":"Masahiko","family":"Nakata","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Toho University School of Medicine  Tokyo 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President, Shizuoka College of Medical Science  Hamamatsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isamu","family":"Ishiwata","sequence":"additional","affiliation":[{"name":"Ishiwata Obstetrics and Gynecologic Hospital  Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoaki","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Mie University  Mie Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Maternal Death Exploratory Committee in Japan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Maternal and child health statistics in Japan","author":"Kamiya 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