Cook Colleen-M, Peek Michael J
Department of Obstetrics and Gynaecology, University of Sydney at Nepean Hospital, Penrith, New South Wales, Australia.
Aust N Z J Obstet Gynaecol. 2004 Feb;44(1):35-8. doi: 10.1111/j.1479-828X.2004.00173.x.
To determine current attitudes and practices regarding the suppression of preterm labour among obstetricians in Australia and New Zealand.
A questionnaire mailed to all Diplomates, Members and Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists in April 2002.
A total of 813 surveys were returned - 33% (470/1412) of Fellows and Members and 11% (322/2806) of Diplomates. The response rate for Australia was 18.9% (759 of 4019) compared to 27.1% (54 of 199) from New Zealand. Routine suppression of preterm labour was attempted by 79% of respondents, primarily to prolong pregnancy for steroid administration (83%) and/or transfer (74%). The gestation for initiation of suppression ranged from 20 to 37 weeks. Tocolysis was discontinued at 32.9 +/- 2.7 weeks (mean +/- SD), range 24-38 weeks. The first choice drug for tocolysis was the beta-adrenergic group (73%), followed by nifedipine (21%). Maintenance tocolysis was used by 34%. Respondents were asked the percentage of women in whom suppression was attempted that achieved: (i) steroid cover--median 80% (range 10-100); (ii) prolongation of pregnancy > or =7 days--50% (0-100); and (iii) prolongation of pregnancy to term--10% (0-100).
Most respondents attempted to suppress preterm labour for steroid administration and/or transfer. However, a wide range of opinions and uncertainty was evident as to the effectiveness of tocolytic therapy in clinical management, the most appropriate drug and drug side-effects.
确定澳大利亚和新西兰产科医生对于抑制早产的当前态度和做法。
2002年4月向澳大利亚和新西兰皇家妇产科医师学院的所有专科医生、会员和研究员邮寄了一份调查问卷。
共收回813份调查问卷——研究员和会员的回复率为33%（470/1412），专科医生的回复率为11%（322/2806）。澳大利亚的回复率为18.9%（4019人中的759人），而新西兰为27.1%（199人中的54人）。79%的受访者尝试常规抑制早产，主要目的是为了延长孕周以便使用类固醇（83%）和/或进行转运（74%）。开始抑制早产的孕周为20至37周。宫缩抑制剂在32.9±2.7周（均值±标准差）停用，范围为24至38周。宫缩抑制剂的首选药物是β-肾上腺素能药物组（73%），其次是硝苯地平（21%）。34%的受访者使用了维持性宫缩抑制剂。受访者被问及尝试抑制早产的女性中达到以下情况的百分比：（i）使用类固醇——中位数为80%（范围10 - 100）；（ii）孕周延长≥7天——50%（0 - 100）；以及（iii）孕周延长至足月——10%（0 - 100）。
大多数受访者尝试抑制早产以便使用类固醇和/或进行转运。然而，在宫缩抑制疗法在临床管理中的有效性、最合适的药物以及药物副作用方面，存在广泛的意见分歧和不确定性。
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