Shaikh Shahida, Shaikh Abdul Hameed, Akhter Saleem, Isran Basma
Chandka Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana.
J Pak Med Assoc. 2012 Jan;62(1):47-50.
To determine the efficacy of transdermal Nitroglycerine patch in idiopathic pre-term labour and foetomaternal outcome.
This quasi-experimental study was conducted at the Obstetrics Unit-II of Shaikh Zayed Hospital for Women, Chandka Medical College, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, from Jan 1 to June 30, 2010. Sixtyfive pregnant women at 28-34 weeks of gestation were recruited after they met the selection criteria based on non-probability consecutive sampling. Initially, 73 patients were selected, but 65 of them completed the treatment, while 8 patients refused to continue. Patients diagnosed with pre-term labour were given glyceryl trinitrate (GTN) 5 mg/12 hours transdermal patch which was applied on the anterior abdominal wall. The second patch of same dose was given after 12 hours. Arrest of labour, prolongation of pregnancy in days or weeks along with side effects of the agent were monitored. Patients were followed till delivery to know the foeto-maternal outcome.
Dramatic effects were seen in around 60 (92.3%), of the total patients who had felt relief from premature labour pains within the first hour and only 5 (7.6%) patients could not go beyond 24 hours, as among them 3 (4.61%) had previous uterine scar and 2 (3.07%) developed ruptured membranes after 12 hours of admission and their babies also could not survive. Mean pregnancy prolongation was 15.35 +/- 9.45 days (min: 4 max: 35), so delivery was deferred up to 48 hours, 3 to 7 days and more than 7 days in 4 (6.15%), 6 (9.23%) and 50 (76.92%) respectively.
Glyceryl trinitrate, trans dermal patch is effective and safe tocolytic in idiopathic preterm labour. By prolonging pregnancy it improves neonatal outcome.
确定硝酸甘油透皮贴剂治疗特发性早产的疗效及母婴结局。
本准实验性研究于2010年1月1日至6月30日在拉卡纳市谢赫·扎耶德妇女医院妇产科二病区（隶属于钱德卡医学院、谢赫·莫赫塔尔玛·贝娜齐尔·布托医科大学）进行。采用非概率连续抽样法，选取65例妊娠28 - 34周的孕妇，这些孕妇符合入选标准。最初选取了73例患者，但其中65例完成了治疗，8例拒绝继续治疗。诊断为早产的患者给予硝酸甘油（GTN）5mg/12小时透皮贴剂，贴于前腹壁。12小时后给予相同剂量的第二贴。监测宫缩停止情况、妊娠延长天数或周数以及药物副作用。对患者进行随访直至分娩，以了解母婴结局。
约60例（92.3%）患者在第一小时内早产疼痛即得到缓解，效果显著；仅5例（7.6%）患者未能超过24小时，其中3例（4.61%）既往有子宫瘢痕，2例（3.07%）入院12小时后胎膜破裂，其婴儿也未能存活。平均妊娠延长时间为15.35±9.45天（最短4天，最长35天），分娩推迟至48小时、3至7天及超过7天的患者分别为4例（6.15%）、6例（9.23%）和50例（76.92%）。
硝酸甘油透皮贴剂治疗特发性早产有效且安全。通过延长孕周可改善新生儿结局。
