In which preterm labor-patients is intravenous maintenance tocolysis effective?
In which preterm labor-patients is intravenous maintenance tocolysis effective?
复制标题
静脉维持安胎对哪些早产患者有效？
DOI：
10.1111/jog.13547
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Saito S.
中科院分区：
文献类型：
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作者：
Yoneda S;Yoneda N;Fukuta K;Shima T;Nakashima A;Shiozaki A;Yoshino O;Kigawa M;Yoshida T;Saito S.
目的评价维持安胎（静脉注射盐酸利托君和/或硫酸镁）对胎膜完整的自发性早产病例是否有效。方法选择维持安胎妊娠至36周的早产患者130例。停止维持安胎后立即分娩（ID）被定义为“有效病例”。对ID与未立即分娩(NID)之间的相关因素进行统计分析。结果停止维持安胎后<两天分娩的患者36例(27.7%)，被定义为有效病例。多元逻辑回归分析显示，入院时羊水白细胞介素-8（≥ 2.3ng/mL；比值比 [OR] 5.6，95% 置信区间 [CI] 2.1–17.6；P< 0.001）、孕前体重指数（≤ 21.4；OR 5.3，95% CI） 2.0–16.2；P< 0.001）和环扎术（OR 3.6，95% CI 1.1–11.8；P= 0.028）是与 ID（< 2 天）相关的独立因素。结论 维持安胎可能对有限的轻度羊膜内炎症病例、瘦女性和环扎术病例有效。如果没有这些临床因素，当临床症状消失时，应停止维持安胎。
AimWe evaluated whether maintenance tocolysis (intravenous ritodrine hydrochloride and/or magnesium sulfate) was effective in cases of spontaneous preterm labor with intact membranes.MethodsOne hundred and thirty preterm labor patients who reached 36 weeks of gestation by maintenance tocolysis were selected. Immediate delivery (ID) after ceasing maintenance tocolysis was defined as an ‘effective case’. The correlated factors between ID and no immediate delivery (NID) were statistically analyzed.ResultsThirty‐six patients delivered < two days after ceasing maintenance tocolysis (27.7%) and were defined as effective cases. Multiple logistic regression analysis revealed that amniotic fluid interleukin‐8 at admission (≥ 2.3 ng/mL; odds ratio [OR] 5.6, 95% confidence interval [CI] 2.1–17.6;P< 0.001), pre‐pregnancy body mass index (≤ 21.4; OR 5.3, 95% CI 2.0–16.2;P< 0.001) and cerclage (OR 3.6, 95% CI 1.1–11.8;P= 0.028) were independent factors correlated with ID (< 2 days).ConclusionMaintenance tocolysis may be effective in limited cases with mild intra‐amniotic inflammation, in lean women and in cerclage cases. Maintenance tocolysis should be ceased in cases without these clinical factors when clinical symptoms disappear.