Borna Sedigheh, Sahabi Noshin
Department of Perinatalogy, Vali-e-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Aust N Z J Obstet Gynaecol. 2008 Feb;48(1):58-63. doi: 10.1111/j.1479-828X.2007.00803.x.
Women with preterm labour that is arrested with tocolytic therapy are at increased risk of recurrent preterm labour. The efficacy of maintenance tocolytic therapy after successful arrest of preterm labour remains controversial.
The purpose of this study was to determine whether supplementation of vaginal progesterone after inhibition of preterm labour is associated with an increased latency period and a decreased recurrent of preterm labour.
This trial was conducted in 70 women who presented with symptoms of threatened preterm labour, who after arrest of uterine activity were then randomised to progesterone therapy or no treatment. Treatment group received progesterone suppository (400 mg) daily until delivery and control group received no treatment.
Longer mean latency until delivery (36/11 +/- 17/9 vs 24/52 +/- 27/2) (mean + standard deviation) days; respiratory distress syndrome 4 (10.8%) vs 12 (36.4%) P = 0.021; low birthweight 10 (27%) vs 17 (51.5%) P = 0.04; and birthweight (3101.54 +/- 587.9 g vs r 2609.39 +/- 662.9 g, P = 0.002), were significantly different between the two groups. No significant differences were found between recurrent preterm labour 13 (35.1%) vs 19 (57.6%), P = 0.092; admission to intensive care unit 9 (24.3%) vs 13 (39.4%), P= 0.205 ; and neonatal sepsis 2 (5.4%) vs 6 (18.2%) P = 0.136, for the progesterone and control groups, respectively.
The use of vaginal progesterone suppository after successful parenteral tocolysis associated with a longer latency preceding delivery but failed to reduce the incidence of readmission for preterm labour.
接受宫缩抑制剂治疗后早产被抑制的女性复发早产的风险增加。早产成功抑制后维持宫缩抑制剂治疗的疗效仍存在争议。
本研究的目的是确定早产被抑制后补充阴道孕酮是否与延长潜伏期及降低早产复发率相关。
本试验纳入70例有早产迹象的女性，子宫活动被抑制后，将其随机分为孕酮治疗组或不治疗组。治疗组每天接受孕酮栓剂（400mg）直至分娩，对照组不接受治疗。
两组之间的平均分娩潜伏期（分别为36/11±17/9天与24/52±27/2天）（均值+标准差）、呼吸窘迫综合征发生率（4例[10.8%]与１２例[36.4%]，P = 0.021）、低出生体重发生率（10例[27%]与17例[51.5%]，P = 0.04）以及出生体重（分别为3101.54±587.9g与2609.39±662.9g，P = 0.002）存在显著差异。孕酮治疗组与对照组在早产复发率（分别为13例[35.1%]与19例[57.6%]，P = 0.092）、入住重症监护病房率（分别为9例[24.3%]与13例[39.4%]，P = 0.205）以及新生儿败血症发生率（分别为2例[5.4%]与6例[18.2%]，P = 0.136）方面未发现显著差异。
在成功进行非肠道宫缩抑制治疗后使用阴道孕酮栓剂可延长分娩前的潜伏期，但未能降低早产再次入院的发生率。
