Ng Qiu Ju, Abdul Rahman Muhammad Fairuz Bin, Lim May Li, Chee Jing Jye, Tan Kok Hian
J Perinat Med. 2015 Jul;43(4):423-8. doi: 10.1515/jpm-2014-0216.
Our objective is to compare the efficacy of combination regimen (salbutamol and nifedipine) against single regimen (nifedipine alone) in preventing preterm births among women with preterm labor.
A total of 76 women with gestational age (GA) ranging from 24+0 to 35+6 weeks, who sought treatment for preterm labor with or without cervical dilatation, were recruited for the prospective cohort study. Of these, 38 (50%) had single tocolytic regimen and 38 (50%) had combination tocolytic regimen. The mean GAs at admission were similar for both groups at 31 weeks (±2.93) for Group 1 and 30.9 weeks (±2.88) for Group 2 (P=0.873). The mean GAs at delivery were 37.8 weeks (±1.98) for the single regimen and 36.2 weeks (±3.26) for the combined regimen (P=0.011). The mean tocolytic to delivery interval for the single regimen was longer at 6.74 weeks (±3.13) as compared with 5.21 weeks (±3.61) for the combination regimen (P<0.05). Those on the combination regimen complained of more adverse effects (P<0.001).
Our study results suggested that the use of nifedipine as a single tocolytic regimen is as effective as the combination regimen in the delay of preterm births and has much less side effects. Hence, we recommend the sole use of nifedipine for the management of preterm labor.
我们的目的是比较联合用药方案(沙丁胺醇和硝苯地平)与单一用药方案(仅使用硝苯地平)在预防早产孕妇早产方面的疗效。
共有76名孕周在24⁺⁰至35⁺⁶周之间、因早产伴或不伴有宫颈扩张而寻求治疗的孕妇被纳入该前瞻性队列研究。其中,38名(50%)采用单一宫缩抑制剂方案,38名(50%)采用联合宫缩抑制剂方案。两组入院时的平均孕周相似,第1组为31周(±2.93),第2组为30.9周(±2.88)(P = 0.873)。单一用药方案组分娩时的平均孕周为37.8周(±1.98),联合用药方案组为36.2周(±3.26)(P = 0.011)。单一用药方案从使用宫缩抑制剂到分娩的平均间隔时间较长,为6.74周(±3.13),而联合用药方案为5.21周(±3.61)(P < 0.05)。联合用药方案组的患者抱怨不良反应更多(P < 0.001)。
我们的研究结果表明,使用硝苯地平作为单一宫缩抑制剂方案在延迟早产方面与联合用药方案一样有效,且副作用少得多。因此,我们建议单独使用硝苯地平来管理早产。