Papatsonis D N M, Timmerman C C M, Oei S G, van Geijn H P
VU Medisch Centrum, afd. Verloskunde en Gynaecologie, Amsterdam.
Ned Tijdschr Geneeskd. 2002 Oct 19;146(42):1980-3.
Preterm birth is the most important cause of perinatal mortality in Europe and North America. Tocolytic agents named beta 2-sympathicomimetics postpone delivery for 24-48 hours, but do not reduce perinatal mortality or morbidity. Calcium antagonists, in particular nifedipine, are more effective tocolytic agents than beta 2-sympathicomimetics in terms of delaying delivery. Meta-analyses have found that calcium antagonists statistically significantly reduced perinatal morbidity and that the number of maternal side effects was statistically significantly lower compared with beta 2-sympathicomimetics. Nifedipine also has the benefit of oral administration, in contrast with beta 2-sympathicomimetics which are administered intravenously. Nifedipine is therefore the first choice in the management of threatening preterm labour.
早产是欧洲和北美的围产期死亡的最重要原因。名为β2-拟交感神经药的宫缩抑制剂可将分娩推迟24至48小时，但不会降低围产期死亡率或发病率。钙拮抗剂，尤其是硝苯地平，在延迟分娩方面比β2-拟交感神经药更有效地抑制宫缩。荟萃分析发现，钙拮抗剂在统计学上显著降低了围产期发病率，并且与β2-拟交感神经药相比，母体副作用的数量在统计学上显著更低。与静脉注射的β2-拟交感神经药相比，硝苯地平还具有口服给药的优点。因此，硝苯地平是处理先兆早产的首选药物。
