Bekkari Y, Lucas J, Beillat T, Chéret A, Dreyfus M
Service de gynécologie-obstétrique et médecine de la reproduction, CHRU Georges-Clemenceau, boulevard Georges-Clemenceau, 14033 Caen cedex, France.
Gynecol Obstet Fertil. 2005 Jul-Aug;33(7-8):483-7. doi: 10.1016/j.gyobfe.2005.05.020.
To assess tocolysis with nifedipine in preterm labour during actual clinical practice in terms of efficacy and safety.
Retrospective observational study during two years including preterm labour between 26 and 33+6 weeks of amenorrhea. Preterm labour was defined by the presence of three or more uterine contractions in 10 minutes associated to cervical modifications diagnosed by vaginal sonography (length<or=25 mm). Patients were excluded if they had more than two fetuses or other gestational pathologies. Tocolysis resulted in oral taking of 30 mg of nifedipine (3x10 mg) with continuous follow-up of blood pressure. Tocolysis was modified when contractions did not disappear. Success was defined when delivery was delayed more than 48 hours. Failure was defined either by a delivery occurring in the first two days of tocolysis or when a modification of treatment was required.
Fifty-eight patients were included, 10 of whom having a twin pregnancy. Success was obtained in 84% of patients (49/58). All of these women did not deliver during the first seven days after introduction of tocolysis. Five patients delivered in the first two days after tocolysis and four others required a change in tocolysis. Mean gestational age at delivery was 37+5 weeks and 35 weeks for single and twin pregnancies, respectively. No maternal or fetal side effects were described.
Nifedipine could be prescribed for tocolysis in actual clinical practice because it seems to have safety and excellent tolerance.
在实际临床实践中,从疗效和安全性方面评估硝苯地平用于早产的保胎治疗效果。
一项为期两年的回顾性观察研究,纳入闭经26至33 + 6周的早产患者。早产定义为10分钟内出现三次或更多次子宫收缩,并经阴道超声检查诊断为宫颈改变(长度≤25 mm)。如果患者怀有两个以上胎儿或患有其他妊娠相关疾病,则排除在外。保胎治疗采用口服30 mg硝苯地平(3×10 mg),并持续监测血压。若宫缩未消失,则调整保胎治疗方案。若分娩延迟超过48小时,则定义为保胎成功。若在保胎治疗的前两天内分娩或需要调整治疗方案,则定义为保胎失败。
共纳入58例患者,其中10例为双胎妊娠。84%的患者(49/58)保胎成功。所有成功保胎的女性在开始保胎治疗后的前七天内均未分娩。5例患者在保胎治疗后的前两天内分娩,另外4例患者需要调整保胎治疗方案。单胎妊娠和双胎妊娠患者分娩时的平均孕周分别为37 + 5周和35周。未发现母体或胎儿有副作用。
在实际临床实践中,硝苯地平可用于早产的保胎治疗,因为它似乎具有安全性和良好的耐受性。