Department of Obstetrics and Gynecology, and Women's Health, Maricopa Integrated Health System, Phoenix, AZ 85008, USA.
Am J Obstet Gynecol. 2012 Mar;206(3):254.e1-5. doi: 10.1016/j.ajog.2011.12.011. Epub 2011 Dec 16.
Various tocolytics are used to suppress uterine contractility in patients in preterm labor. Progesterone (P4) is used in patients at high risk for preterm delivery. In this study, we evaluated the effects of various tocolytics with and without P4 to examine effects on uterine contractility.
Uterine tissues (n = 280) from women undergoing cesarean at term were exposed in vitro to various agents (vehicle, magnesium sulfate [MgSO(4)], nifedipine, indomethacin, or pinacidil-all with and without P4). Contractility was measured before and after addition of the various agents.
P4 alone at 10(-5) mol/L concentration has little effect to inhibit contractility (P ≥ .05). MgSO(4) (2-8 × 10(-3) mol/L) inhibits uterine contractility (P < .05) but there is no change when combined with P4 (P > .05). Nifedipine (10(-8) mol/L) and indomethacin (10(-5) mol/L) inhibit contractions alone (P < .05) and to a greater extent when combined with P4 (P < .05). P4 significantly (P < .05) reduced the effects of pinacidil (10(-6.5) mol/L).
Combinations of P4 with nifedipine or indomethacin, but not MgSO(4), might be used to effectively suppress preterm labor.
各种保胎药物被用于抑制早产孕妇的子宫收缩。孕激素(P4)被用于有早产风险的患者。在这项研究中,我们评估了有或没有 P4 的各种保胎药物对子宫收缩的影响。
对因剖宫产而足月分娩的妇女的子宫组织(n=280)进行体外暴露,使其接触各种药物(载体、硫酸镁[MgSO(4)]、硝苯地平、吲哚美辛或吡那地尔-均与或不与 P4 联合)。在添加各种药物前后测量收缩性。
浓度为 10(-5) mol/L 的 P4 单独使用对抑制收缩性的作用很小(P≥.05)。硫酸镁(2-8×10(-3) mol/L)抑制子宫收缩(P<.05),但与 P4 联合使用时无变化(P>.05)。硝苯地平(10(-8) mol/L)和吲哚美辛(10(-5) mol/L)单独抑制收缩(P<.05),与 P4 联合使用时抑制作用更强(P<.05)。P4 显著降低了吡那地尔(10(-6.5) mol/L)的作用(P<.05)。
P4 与硝苯地平或吲哚美辛联合使用,而不是与硫酸镁联合使用,可能用于有效抑制早产。