Motazedian Shahdokht, Ghaffarpasand Fariborz, Mojtahedi Khatereh, Asadi Nasrin
Fasa University of Medical Sciences, Fasa, Iran.
Ann Saudi Med. 2010 Sep-Oct;30(5):370-5. doi: 10.4103/0256-4947.67079.
Preterm labor (PTL) is a common medical problem during pregnancies and is associated with neonatal mortality and morbidity. Beta-adrenergic agonists are among the most commonly used tocolytic agents. The aim of this study was to compare the effectiveness, safety and adverse effects of terbutaline with those of salbutamol in the prolongation of pregnancy beyond 48 hours and until 37 weeks of gestation.
Two hundred women with PTL were randomly assigned to receive subcutaneous terbutaline (250 μg) or intravenous salbutamol (0.1 mg) followed by oral terbutaline (20 mg/d) or oral salbutamol (24 mg/d) as maintenance. The efficacy, side effects and complications after 48 hours and until 37 weeks of gestation were analyzed and compared.
There was no significant difference between the two groups in success rate within 48 hours (P= .091). Gestational age at delivery (P=.031) and the number of days for which the gestation was prolonged (P=.024) were significantly higher in those receiving terbutaline. Adverse effects, including tachycardia (P=.007) and anxiety (P=.006), were experienced more in the salbutamol group. Birth weight was significantly lower in the salbutamol group (P=.001).
Terbutaline provided more effective tocolysis with fewer adverse effects and a better neonatal outcome. However, terbutaline and salbutamol are equally effective in the first 48 hours.
早产是孕期常见的医学问题，与新生儿死亡率和发病率相关。β-肾上腺素能激动剂是最常用的宫缩抑制剂之一。本研究的目的是比较特布他林与沙丁胺醇在延长妊娠至48小时以上并直至妊娠37周方面的有效性、安全性及不良反应。
200例早产妇女被随机分配接受皮下注射特布他林（250μg）或静脉注射沙丁胺醇（0.1mg），随后分别口服特布他林（20mg/d）或口服沙丁胺醇（24mg/d）作为维持治疗。分析并比较48小时后直至妊娠37周时的疗效、副作用及并发症。
两组在48小时内的成功率无显著差异（P = 0.091）。接受特布他林治疗的患者分娩时的孕周（P = 0.031）及妊娠延长天数（P = 0.024）显著更高。沙丁胺醇组出现更多不良反应，包括心动过速（P = 0.007）和焦虑（P = 0.006）。沙丁胺醇组出生体重显著更低（P = 0.001）。
特布他林在抑制宫缩方面更有效，不良反应更少，新生儿结局更好。然而，特布他林和沙丁胺醇在最初48小时内效果相当。
