Burke M S, Porreco R P, Day D, Watson J D, Haverkamp A D, Orleans M, Luckey D
Department of Obstetrics and Gynecology, Denver General Hospital, CO.
J Perinatol. 1989 Sep;9(3):296-300.
Fifty patients were compared for the purpose of investigating the usefulness of intrauterine resuscitation with tocolysis (IURT). Terbutaline was given, as an intravenous bolus, to 31 women in labor in whom fetal distress was diagnosed and urgent delivery by cesarean section was indicated. In alternate months, a control group of 19 women with similar diagnoses was urgently delivered after standard interventions such as maternal positioning, oxygen administration, hydration, and discontinuation of oxytocin. Improvement in perinatal outcome was shown in infants after IURT. Apgar scores were less than 7 in 42% of the study group and in 71% of the control group at 1 minute (P = .04). Five-minute Apgar scores less than 7 occurred in 7% of the study group and 24% of the control group. A low venous pH was seen in 55% of the control group compared with 29% of the infants resuscitated with terbutaline. Estimated maternal blood loss and hematocrit change was not different in the two groups. Maternal blood pressure and pulse changes following IURT were modest and of doubtful significance. We conclude that intravenous terbutaline administered as a bolus injection at the time of fetal distress in labor improves infant outcome as evidenced by more vigorous Apgar scores and less acidemia without significant adverse physiologic effects on the mother.
为研究宫缩抑制剂辅助下的宫内复苏术（IURT）的有效性，对50例患者进行了比较。对31例诊断为胎儿窘迫且需紧急剖宫产分娩的临产妇女静脉推注特布他林。在交替的月份里，对19例诊断相似的妇女组成的对照组，在进行诸如产妇体位调整、吸氧、补液及停用缩宫素等标准干预措施后进行紧急分娩。IURT后婴儿围产期结局有所改善。研究组1分钟时Apgar评分低于7分的比例为42%，对照组为71%（P = 0.04）。研究组5分钟时Apgar评分低于7分的比例为7%，对照组为24%。对照组55%的婴儿出现低静脉血pH值，而接受特布他林复苏的婴儿这一比例为29%。两组产妇估计失血量和血细胞比容变化无差异。IURT后产妇血压和脉搏变化较小，意义存疑。我们得出结论，在临产胎儿窘迫时静脉推注特布他林可改善婴儿结局，表现为Apgar评分更高、酸血症更少，且对母亲无明显不良生理影响。
