Valenzuela G J, Foster T C
Department of Obstetrics and Gynecology, San Bernardino County Medical Center, California.
Obstet Gynecol. 1990 May;75(5):762-4.
Magnesium sulfate has been shown in vivo and in vitro to decrease the frequency of uterine contractions while maintaining the amplitude; we therefore decided to assess the use of magnesium sulfate infusion in cases of uterine hyperstimulation. The medical records were reviewed retrospectively for 37 term pregnant patients diagnosed as having uterine hyperstimulation during labor. None of them had medical or obstetric complications. Twenty-two of them received oxytocin augmentation for abnormal labor. Although the vast majority of these patients had a decrease of the hyperstimulation while being given the magnesium, 31.8% in the group receiving oxytocin alone (P less than .05). Fifteen additional patients received magnesium sulfate for uterine hyperstimulation although they were not receiving oxytocin; of these, 16.7% required cesarean delivery. This rate was no different from that of the patients who required labor augmentation, but was double the overall primary cesarean rate at our hospital. There appears to be a group of patients with abnormal uterine activity (either spontaneous or associated with oxytocin augmentation) that responds to treatment with magnesium sulfate.
硫酸镁在体内和体外均已显示出能降低子宫收缩频率,同时维持收缩幅度;因此,我们决定评估硫酸镁输注在子宫过度刺激病例中的应用。对37例足月妊娠患者的病历进行回顾性分析,这些患者在分娩期间被诊断为子宫过度刺激。她们均无内科或产科并发症。其中22例因产程异常接受了缩宫素加强宫缩治疗。尽管这些患者中的绝大多数在使用硫酸镁时子宫过度刺激有所减轻,但单独接受缩宫素治疗的患者中有31.8%的情况并非如此(P小于0.05)。另有15例患者虽未接受缩宫素治疗,但因子宫过度刺激接受了硫酸镁治疗;其中,16.7%的患者需要剖宫产。该比率与需要加强宫缩的患者比率无差异,但却是我院总体初次剖宫产率的两倍。似乎有一组子宫活动异常(无论是自发的还是与缩宫素加强宫缩相关)的患者对硫酸镁治疗有反应。