Kawagoe Yasuyuki, Sameshima Hiroshi, Ikenoue Tsuyomu, Yasuhi Ichiro, Kawarabayashi Tatsuhiko
Department of Obstetrics and Gynecology, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, Japan.
J Pregnancy. 2011;2011:965060. doi: 10.1155/2011/965060. Epub 2011 Jun 16.
We evaluated the efficacy of magnesium sulfate as a second-line tocolysis for 48 hours.
A multi-institutional, simple 2-arm randomized controlled trial was performed. Forty-five women at 22 to 34 weeks of gestation were eligible, whose ritodrine did not sufficiently inhibit uterine contractions. After excluding 12 women, 33 were randomly assigned to either magnesium alone or combination (ritodrine and magnesium). The treatment was determined as effective if the frequency of uterine contraction was reduced by 30% at 48 hours of the treatment.
After magnesium sulfate infusion, 90% prolonged their pregnancy for >48 hours. Combination therapy was effective in 95% (18/19), which was significantly higher than 50% (7/14) for magnesium alone.
This randomized trial revealed that combination therapy significantly reduced uterine contractions, suggesting that adjuvant magnesium with ritodrine is recommended, rather than changing into magnesium alone, when uterine contractions are intractable with ritodrine infusion.
我们评估了硫酸镁作为二线宫缩抑制剂使用48小时的疗效。
开展了一项多机构、简单的双臂随机对照试验。45名妊娠22至34周的女性符合条件，她们使用利托君后未能充分抑制宫缩。排除12名女性后，33名被随机分为单独使用镁剂组或联合使用组（利托君和镁剂）。如果治疗48小时后宫缩频率降低30%，则判定治疗有效。
输注硫酸镁后，90%的患者妊娠延长超过48小时。联合治疗的有效率为95%（18/19），显著高于单独使用镁剂组的50%（7/14）。
这项随机试验表明，联合治疗能显著减少宫缩，这表明当利托君输注难以控制宫缩时，推荐利托君联合镁剂，而非单纯更换为镁剂。
