Husslein Peter
Department of Obstetrics and Gynecology, University of Vienna Medical School, Austria.
Acta Obstet Gynecol Scand. 2002 Jul;81(7):633-41. doi: 10.1034/j.1600-0412.2002.810709.x.
The incidence of preterm birth has remained unchanged for the last few decades. This is due, in part, to the complex etiology of preterm labor, and the limited ability of tocolytic agents to prolong pregnancy as a result of limited efficacy and poor safety profiles. The recent introduction of the oxytocin antagonist, atosiban, represents a new generation of uterine-specific tocolytics, which are associated with more favorable safety profiles. This paper discusses the rationale behind the development of the oxytocin antagonists and provides a review of the phase II and III trials that have investigated atosiban. Also included is a retrospective analysis of 83 women assessed in the Vienna Medical School, providing an insight into the benefits associated with atosiban in the everyday clinical setting. The introduction of a safer tocolytic agent offers the potential to change the current approach to the management of preterm labor. This includes a prolonged period of treatment at earlier or later gestational ages and possibly an extended use to women with contraindications who would normally have been excluded from treatment, e.g. preterm premature rupture of the membranes.
在过去几十年中，早产的发生率一直保持不变。部分原因在于早产 labor 的病因复杂，以及由于疗效有限和安全性不佳，宫缩抑制剂延长妊娠的能力有限。催产素拮抗剂阿托西班的近期引入代表了新一代子宫特异性宫缩抑制剂，其具有更有利的安全性。本文讨论了催产素拮抗剂开发背后的基本原理，并对研究阿托西班的 II 期和 III 期试验进行了综述。还包括对维也纳医学院评估的 83 名女性的回顾性分析，深入了解阿托西班在日常临床环境中的益处。引入更安全的宫缩抑制剂有可能改变当前早产 labor 的管理方法。这包括在更早或更晚的孕周进行更长时间的治疗，并且可能将其扩展用于通常会被排除在治疗之外的有禁忌症的女性，例如胎膜早破早产。
