Richter Oliver N, Dorn C, van de Vondel P, Ulrich U, Schmolling J
Department of Obstetrics and Gynecology, University of Bonn School of Medicine, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany.
Arch Gynecol Obstet. 2005 Jun;272(1):26-30. doi: 10.1007/s00404-004-0652-8. Epub 2004 Jul 23.
Atosiban has been shown to be an effective tocolytic agent with a low rate of side effects during 24 to 33 weeks of gestation. Atosiban acts through selective, competitive inhibition of both oxytocin and vasopressin, so that there are reasons to assume that a tocolytic effect can also be achieved earlier in the pregnancy.
In this prospective, randomized pilot study, 20 women in the 18th through 24th week of gestation who presented at our hospital with preterm labor were treated with atosiban. In the control group 20 women received saline infusions. All patients received antibiotic therapy. A cervical cerclage was performed when indicated as was correction of the vaginal pH.
The tocolytic effect began after 3-10 min (median: 6.5 min). Treatment time until the complete absence of contractions was 3-12 h (median: 7.5 h). Pregnancies were prolonged between 11.1 and 21.7 weeks (median: 15.6 weeks) in the atosiban group vs. 10.5-19.1 weeks in the control group. If well tolerated, atosiban was continued. There were no significant alterations in the routine laboratory parameters, circulation parameters, and fluid balance.
In summary, atosiban showed itself to be effective for tocolytic treatment for premature labor, even during 18 and 24 weeks of pregnancy, while exhibiting its known, favorable profile of side effects.
阿托西班已被证明是一种有效的宫缩抑制剂，在妊娠24至33周期间副作用发生率较低。阿托西班通过对催产素和血管加压素的选择性竞争性抑制发挥作用，因此有理由推测在妊娠早期也能实现宫缩抑制效果。
在这项前瞻性随机试验研究中，20名妊娠18至24周因早产前来我院就诊的女性接受了阿托西班治疗。对照组20名女性接受生理盐水输注。所有患者均接受抗生素治疗。如有指征则进行宫颈环扎术，并纠正阴道pH值。
宫缩抑制效果在3 - 10分钟后开始（中位数：6.5分钟）。直至宫缩完全消失的治疗时间为3 - 12小时（中位数：7.5小时）。阿托西班组妊娠延长了11.1至21.7周（中位数：15.6周），而对照组为10.5至19.1周。如果耐受性良好，则继续使用阿托西班。常规实验室参数、循环参数和液体平衡均无显著变化。
总之，阿托西班对早产的宫缩抑制治疗显示出有效性，即使在妊娠18至24周期间，同时展现出其已知的良好副作用特征。
