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阴道用孕酮在双胎妊娠早产宫缩抑制治疗中的作用:一项安慰剂对照随机试验的二次分析

Effect of vaginal progesterone in tocolytic therapy during preterm labor in twin pregnancies: Secondary analysis of a placebo-controlled randomized trial.

作者信息

Hernandez Wagner R, Francisco Rossana P V, Bittar Roberto E, Gomez Ursula T, Zugaib Marcelo, Brizot Maria L

机构信息

Department of Obstetrics and Gynecology, São Paulo University Medical School, São Paulo, Brazil.

出版信息

J Obstet Gynaecol Res. 2017 Oct;43(10):1536-1542. doi: 10.1111/jog.13421. Epub 2017 Jul 14.

Abstract

AIM

Our aim was to investigate the effect of the prophylactic use of vaginal progesterone on the latency period from the initiation of tocolytic therapy to delivery in twin pregnancies with preterm labor.

METHODS

This study was a secondary analysis of a randomized, double-blind, placebo-controlled trial of twin pregnancies in mothers who were exposed to a 200 mg vaginal progesterone ovule or a placebo ovule daily from 18 to 34 weeks gestation. Patients who were administered tocolysis with Atosiban because of preterm labor were included. The latency from tocolysis to delivery, mean gestational age at delivery and the rates of delivery within 48 h and within seven days were compared between progesterone and placebo groups.

RESULTS

The analysis included 27 women in the progesterone group and 30 in the placebo group. The baseline characteristics were similar between the groups. Overall, there were no differences in the latency period to delivery (17.54 ± 13.54 days and 21.58 ± 13.52 days; P = 0.289), rates of delivery within 48 h (14.8% and 6.7%; P = 0.40) or within seven days (29.64% and 23.3%; P = 0.76) or mean gestational age at delivery (32.53 ± 3.33 and 34.13 ± 2.87; P = 0.08) between the progesterone and placebo groups, respectively.

CONCLUSIONS

Prophylactic use of 200 mg of vaginal progesterone does not influence the latency to delivery in women with twin pregnancies treated with tocolysis because of preterm labor.

摘要

目的

我们的目的是研究预防性使用阴道孕酮对早产双胎妊娠中从开始使用宫缩抑制剂治疗到分娩的潜伏期的影响。

方法

本研究是一项对双胎妊娠母亲进行的随机、双盲、安慰剂对照试验的二次分析,这些母亲在妊娠18至34周期间每天接受200毫克阴道孕酮栓剂或安慰剂栓剂。纳入因早产接受阿托西班宫缩抑制治疗的患者。比较孕酮组和安慰剂组从宫缩抑制到分娩的潜伏期、分娩时的平均孕周以及48小时内和7天内的分娩率。

结果

分析包括孕酮组的27名女性和安慰剂组的30名女性。两组的基线特征相似。总体而言,孕酮组和安慰剂组在分娩潜伏期(17.54±13.54天和21.58±13.52天;P = 0.289)、48小时内分娩率(14.8%和6.7%;P = 0.40)或7天内分娩率(29.64%和23.3%;P = 0.76)或分娩时的平均孕周(32.53±3.3和34.13±2.87;P = 0.08)方面均无差异。

结论

对于因早产接受宫缩抑制治疗的双胎妊娠女性,预防性使用200毫克阴道孕酮不会影响其分娩潜伏期。

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