静脉注射沙丁胺醇用于外倒转术

Intravenous salbutamol for external cephalic version.

作者信息

Vani Subramaniam, Lau Soon Yen, Lim Boon Kiong, Omar Siti Zawiah, Tan Peng Chiong

机构信息

Department of Obstetrics and Gynecology, Maternity Hospital Penang, Penang, Malaysia.

出版信息

Int J Gynaecol Obstet. 2009 Jan;104(1):28-31. doi: 10.1016/j.ijgo.2008.08.014. Epub 2008 Oct 15.

DOI:10.1016/j.ijgo.2008.08.014

PMID:18922525

Abstract

OBJECTIVE

To evaluate the success of external cephalic version (ECV) using an adjusted bolus dose of intravenous salbutamol compared with no tocolysis.

METHODS

An open-label randomized study of 114 women with a term breech fetus randomized to receive either an intravenous bolus dose of 0.1 mg salbutamol with further boluses every 5 minutes, as required, before commencing ECV, or no tocolysis. Primary outcomes were successful ECV and rate of cesarean delivery.

RESULTS

Salbutamol tocolysis resulted in a higher rate of successful ECV compared with no tocolysis (70.2% [40/57] vs 36.8% [21/57]; RR 1.9, 95% CI 1.3-2.8; P<0.001). Cesarean delivery rate was lower in the salbutamol group compared with the control group (31.6% [18/57] vs 63.2% [36/57]; RR 0.5, 95% CI 0.3-0.8; P=0.001). Salbutamol dose ranged from 0.1-0.4 mg and outcome was not related to dose.

CONCLUSION

Adjusted dose intravenous salbutamol tocolysis prior to ECV increases its success rate and reduces the cesarean delivery rate.

摘要

目的

评估在实施外倒转术（ECV）时，使用调整后的静脉注射沙丁胺醇推注剂量与不进行宫缩抑制相比的成功率。

方法

一项开放标签随机研究，纳入114例足月臀位胎儿孕妇，随机分为两组，一组在开始ECV前接受静脉推注0.1mg沙丁胺醇，并根据需要每5分钟追加推注一次，另一组不进行宫缩抑制。主要结局指标为ECV成功及剖宫产率。

结果

与不进行宫缩抑制相比，沙丁胺醇宫缩抑制使ECV成功率更高（70.2%[40/57]对36.8%[21/57]；RR 1.9，95%CI 1.3 - 2.8；P<0.001）。沙丁胺醇组剖宫产率低于对照组（31.6%[18/57]对63.2%[36/57]；RR 0.5，95%CI 0.3 - 0.8；P = 0.001）。沙丁胺醇剂量范围为0.1 - 0.4mg，结局与剂量无关。