Morrison John C, Chauhan Suneet P, Carroll C Shannon, Bofill James A, Magann Everett F
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, USA.
Am J Obstet Gynecol. 2003 Jun;188(6):1460-5; discussion 1465-7. doi: 10.1067/mob.2003.399.
This study was undertaken to study the effectiveness of continuous subcutaneous terbutaline (SQT) in the home after recurrent preterm labor (RPTL).
Women with RPTL at less than 32 weeks' gestation were treated with continuous SQT administered in the home compared with matched control patients.
Fifteen SQT patients were compared with 45 women (3:1) treated with no tocolytic therapy after hospitalization. Gestational age at delivery more than 37 weeks (53% vs 4%), percentage delivered at less than 32 weeks (0% vs 47%), overall and pregnancy prolongation (49.8 +/- 19.2 days vs 24.5 +/- 12.8 days) were all significantly better in the study group (P <.001). The total number of maternal hospital days (9.8 +/- 2.1 vs 15.9 +/- 7.4, P <.0001), duration of NICU stay (1.9 +/- 4.9 vs 19.8 +/- 29.3 days, P <.001), and total cost for newborn care (6,995 +/- 14,822 US dollars vs 62,033 +/- 89,978 US dollars, P <.002) favored the study patients. For every dollar spent on SQT, there was a savings of 4.67 US dollars in newborn hospital costs for control patients.
In this small study, the use of SQT significantly prolongs pregnancy, decreases serious neonatal complications, and reduces the duration of hospitalization for both mother and infant, as well as neonatal costs.
本研究旨在探讨复发性早产(RPTL)后在家中持续皮下注射特布他林(SQT)的有效性。
将妊娠小于32周的复发性早产妇女与匹配的对照患者进行比较,前者在家中接受持续SQT治疗。
15例接受SQT治疗的患者与45例(3:1)住院后未接受宫缩抑制剂治疗的妇女进行比较。研究组分娩时的孕周大于37周(53%对4%)、小于32周分娩的比例(0%对47%)、总体妊娠延长时间(49.8±19.2天对24.5±12.8天)均显著更好(P<.001)。母亲住院总天数(9.8±2.1对15.9±7.4,P<.0001)、新生儿重症监护病房(NICU)住院时间(1.9±4.9对19.8±29.3天,P<.001)以及新生儿护理总费用(6995±14822美元对62033±89978美元,P<.002)均有利于研究组患者。每花费1美元用于SQT治疗,对照患者的新生儿住院费用可节省4.67美元。
在这项小型研究中,使用SQT可显著延长孕周,减少严重的新生儿并发症,并缩短母婴住院时间以及降低新生儿费用。