Pregnancy drug blamed for deaths of women: Doctors call for reappraisal of a treatment used to prevent premature labour amid fears over the dangers. Liz Hunt reports

TWO YOUNG women died after being given a drug to stop premature labour which, according to increasing medical evidence, is of no value in improving survival of babies born before term.

Leading doctors are calling for a reappraisal of the use of the drug ritodrine in labour wards, and for guidelines to be drawn up by every maternity unit that stocks it.

There is evidence that both deaths - which occurred less than year apart - were the result of incorrect use of the drug in women whose babies would probably have been born healthy without it. Hospital staff also failed to recognise the serious lung problems it caused and so life-saving treatment was not given soon enough.

Ritodrine acts on the muscles of the womb and is used to delay premature labour for up to 48 hours. Its side-effects range from flushing and sweating, increased heart rate, lowered blood pressure, to pulmonary oedema (water-logged lungs) which was a factor in the deaths. In 1992, 7,000 women in the UK received the drug.

Donald Gibb, a consultant obstetrician and gynaecologist at King's College Hospital, London, said yesterday that it was 'outrageous' that any labour ward staff should be ignorant of the drug. 'Given the well-acknowledged dangers of ritodrine, every unit should have a protocol to guide doctors on the use of this dangerous drug in labour wards.'

He said there was evidence that the drug was being given to women who did not need it. Babies born early - at 33 weeks onwards - usually do very well on their own and delaying delivery is of no advantage, he said. The women who died were at least 33 weeks pregnant. The only justification for its use was in women who go into labour between 28 and 32 weeks, when the drug can 'buy time' during which steroid drugs can be given to mature a premature baby's lungs.

Another consultant, who asked not to be named, said he believed that there were 'close calls occurring everywhere' because of ignorance about the drug. The manufacturers, Duphar, say they are aware of 72 cases of pulmonary oedema and 12 deaths due to the drug. However, some doctors believe that problems are more common but are not always linked with ritodrine. Dr Adrian Grant, director of the National Perinatal Trials Unit at the Radcliffe Infirmary, Oxford, said: 'At best, the use of ritodrine is limited. There is very little strong evidence to support its use except in special circumstances.'

The women who died were in good health and had no history of lung or heart disease. Samantha Howard, 22, of Bushey, Watford, died in September 1991 at Hillingdon Hospital NHS Trust, Middlesex, from lack of oxygen to the lungs caused by complications of the drug. Her daughter Zoe was born healthy.

Deborah Coram, 20, from Walderslade, Chatham, died in July last year after a healthy son, Christopher, was delivered by Caesarean section at Medway Hospital, Gillingham. She suffered a heart attack brought on by lung disease linked with the drug.

Both women were given the drug in salt solution - which increases the risk of lung problems - rather than in sucrose which the manufacturers recommend. When the women complained of chest pain and breathing problems, an immediate link with the drug was not made.

Concerns about ritodrine first surfaced in the early 1980s when cases of pulmonary oedema were reported. In a paper published in the British Journal of Obstetrics and Gynaecology in 1988, researchers at the National Perinatal Epidemiology Unit who reviewed all previous trials, concluded that although ritodrine and related drugs delayed delivery, 'no beneficial effect of this treatment on perinatal mortality or severe neonatal respiratory disorders could be detected.'

A more recent paper in the New England Journal Of Medicine by Canadian researchers confirmed these findings, and has led the US Food and Drug Administration to review the drug.

Ritodrine (also known as Yutopar) has been in use for about 20 years and 4 million women have been treated with it world-wide, according to Duphar. Dr John Peter, managing director of Duphar, said ritodrine was safe when used properly and that the company was not responsible for the 'communication problems' which lead to the drug's improper use. He admitted that there was less need for the drug as neonatal care improved.

(Photograph omitted)

Start your day with The Independent, sign up for daily news emails
Life and Style
Fans line up at the AVNs, straining to capture a photo of their favourite star
life Tim Walker asks how much longer it can flesh out an existence
Life and Style
Every minute of every day, Twitter is awash with anger as we seek to let these organisations know precisely what we think of them
techWhen it comes to vitriol, no one on attracts our ire more than big businesses offering bad service
Professor David Nutt wants to change the way gravely ill patients are treated in Britain
people Why does a former Government tsar believe that mind-altering drugs have a place on prescription?
Norway’s ‘The Nordland Line – Minute by Minute, Season by Season’ continues the trend of slow TV
Have you tried new the Independent Digital Edition apps?
ebooksA special investigation by Andy McSmith
Arts and Entertainment
Jonny Evans has pleaded not guilty to an FA charge for spitting at Papiss Cisse
Life and Style
Kate Moss will make a cameo appearance in David Walliams' The Boy in the Dress
The image released by the Salvation Army, using 'The Dress'
Liverpool defender Kolo Toure
football Defender could make history in the FA Cup, but African Cup of Nations win means he's already content
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

Ashdown Group: Technical Presales Consultant - London - £65,000 OTE.

£65000 per annum: Ashdown Group: Technical Presales Engineer - central London ...

Recruitment Genius: Physiotherapist / Sports Therapist

£20000 - £50000 per annum: Recruitment Genius: A Physiotherapist / Sports Ther...

Recruitment Genius: Sales Executive / Advisor

£8 - £9 per hour: Recruitment Genius: Sales Executives / Advisors are required...

Recruitment Genius: Warehouse Operative

£14000 - £15000 per annum: Recruitment Genius: An opportunity has arisen for a...

Day In a Page

Homeless Veterans campaign: Donations hit record-breaking £1m target after £300,000 gift from Lloyds Bank

Homeless Veterans campaign

Donations hit record-breaking £1m target after huge gift from Lloyds Bank
Flight MH370 a year on: Lost without a trace – but the search goes on

Lost without a trace

But, a year on, the search continues for Flight MH370
Germany's spymasters left red-faced after thieves break into brand new secret service HQ and steal taps

Germany's spy HQ springs a leak

Thieves break into new €1.5bn complex... to steal taps
International Women's Day 2015: Celebrating the whirlwind wit of Simone de Beauvoir

Whirlwind wit of Simone de Beauvoir

Simone de Beauvoir's seminal feminist polemic, 'The Second Sex', has been published in short-form for International Women's Day
Mark Zuckerberg’s hiring policy might suit him – but it wouldn’t work for me

Mark Zuckerberg’s hiring policy might suit him – but it wouldn’t work for me

Why would I want to employ someone I’d be happy to have as my boss, asks Simon Kelner
Confessions of a planespotter: With three Britons under arrest in the UAE, the perils have never been more apparent

Confessions of a planespotter

With three Britons under arrest in the UAE, the perils have never been more apparent. Sam Masters explains the appeal
Russia's gulag museum 'makes no mention' of Stalin's atrocities

Russia's gulag museum

Ministry of Culture-run site 'makes no mention' of Stalin's atrocities
The big fresh food con: Alarming truth behind the chocolate muffin that won't decay

The big fresh food con

Joanna Blythman reveals the alarming truth behind the chocolate muffin that won't decay
Virginia Ironside was my landlady: What is it like to live with an agony aunt on call 24/7?

Virginia Ironside was my landlady

Tim Willis reveals what it's like to live with an agony aunt on call 24/7
Paris Fashion Week 2015: The wit and wisdom of Manish Arora's exercise in high camp

Paris Fashion Week 2015

The wit and wisdom of Manish Arora's exercise in high camp
8 best workout DVDs

8 best workout DVDs

If your 'New Year new you' regime hasn’t lasted beyond February, why not try working out from home?
Paul Scholes column: I don't believe Jonny Evans was spitting at Papiss Cissé. It was a reflex. But what the Newcastle striker did next was horrible

Paul Scholes column

I don't believe Evans was spitting at Cissé. It was a reflex. But what the Newcastle striker did next was horrible
Miguel Layun interview: From the Azteca to Vicarage Road with a million followers

From the Azteca to Vicarage Road with a million followers

Miguel Layun is a star in Mexico where he was criticised for leaving to join Watford. But he says he sees the bigger picture
Frank Warren column: Amir Khan ready to meet winner of Floyd Mayweather v Manny Pacquiao

Khan ready to meet winner of Mayweather v Pacquiao

The Bolton fighter is unlikely to take on Kell Brook with two superstar opponents on the horizon, says Frank Warren
War with Isis: Iraq's government fights to win back Tikrit from militants - but then what?

Baghdad fights to win back Tikrit from Isis – but then what?

Patrick Cockburn reports from Kirkuk on a conflict which sectarianism has made intractable