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炎症和感染风险因素与早产患者对宫缩抑制剂的反应相关。

Inflammatory and infectious risk factors are associated with the response to tocolysis in patients with preterm labor.

作者信息

Torricelli Michela, Voltolini Chiara, Conti Nathalie, De Bonis Maria, Biliotti Giulia, Picciolini Enrico, Petraglia Felice

机构信息

Department of Pediatrics, University of Siena, Siena, Italy.

出版信息

J Matern Fetal Neonatal Med. 2011 Jan;24(1):43-6. doi: 10.3109/14767058.2010.482614. Epub 2010 Jun 29.

Abstract

OBJECTIVE

Inflammation/infection is the most frequent conditions leading to preterm delivery (PTD). A few studies have assessed the clinical efficacy of long-term tocolysis with ritodrine hydrochloride. In this study, the relationship among inflammatory/infective risk factors of PTD, the response to long-term tocolysis, and timing of delivery were evaluated in women with preterm labor.

METHODS

On the basis of different responses to long-term tocolysis, defined as ≥ 7 days tocolysis, the cohort were classified as: (i) patients delivering at term (Group A) and (ii) patients delivering preterm (group B). Group B was subclassified as: (i) delivery before 48 h (group B1); (ii) delivery between 48 h and 7 days (Group B2), and (iii) delivery after 7 days (Group B3). Group B is divided in early preterm (<32 weeks) (Group B early) and late PTD (32-36 weeks) (Group B late).

RESULTS

Group A delivered at term and Group B preterm. Group B showed significantly higher (p < 0.0001) rate of CRP, bacterial vaginosis, and chorioamnionitis at placental histological examination than Group A. The same parameters were statistically higher (p < 0.0001) in group B1 than in B3. CRP, chorioamnionitis at placental histological examination was statistically higher (p < 0.0001) in Group B early than in Group B late.

CONCLUSIONS

This retrospective study suggested that in women affected by preterm labor, the long-term tocolysis with intravenous ritodrine is able to prolong gestation beyond 7 days, in absence of inflammatory/infective risk factors of PTD.

摘要

目的

炎症/感染是导致早产(PTD)最常见的情况。一些研究评估了盐酸利托君长期保胎治疗的临床疗效。在本研究中,对早产孕妇中PTD的炎症/感染风险因素、长期保胎治疗的反应以及分娩时间之间的关系进行了评估。

方法

根据对长期保胎治疗(定义为保胎治疗≥7天)的不同反应,将队列分为:(i)足月分娩的患者(A组)和(ii)早产的患者(B组)。B组又细分为:(i)48小时前分娩(B1组);(ii)48小时至7天之间分娩(B2组),以及(iii)7天后分娩(B3组)。B组分为早期早产(<32周)(B早期组)和晚期PTD(32 - 36周)(B晚期组)。

结果

A组足月分娩,B组早产。B组胎盘组织学检查时的CRP、细菌性阴道病和绒毛膜羊膜炎发生率显著高于A组(p < 0.0001)。B1组的相同参数在统计学上高于B3组(p < 0.0001)。B早期组胎盘组织学检查时的CRP、绒毛膜羊膜炎在统计学上高于B晚期组(p < 0.0001)。

结论

这项回顾性研究表明,在早产孕妇中,在不存在PTD的炎症/感染风险因素的情况下,静脉注射盐酸利托君进行长期保胎治疗能够将妊娠期延长至7天以上。

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