Güden Mahmut, Akkurt Mehmet Özgür, Eriş Yalçın Serenat, Coşkun Bora, Akkurt Iltaç, Yavuz And, Yirci Bülent, Kandemir Necmi Ömer
Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, Ankara, Turkey.
Süleyman Demirel University Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Perinatology, Isparta, Turkey.
Turk J Obstet Gynecol. 2016 Jun;13(2):85-89. doi: 10.4274/tjod.25993. Epub 2016 Jun 15.
To investigate the effects of two tocolytics, nifedipine and magnesium sulfate, on Doppler indices in maternal and fetal vessels.
We recruited 100 pregnant women with preterm birth between 24-36 gestational weeks who were admitted to our tertiary center over a two-year period. Patients were allocated to nifedipine (n=49) and magnesium sulfate (n=51) groups and Doppler indices of umbilical, middle cerebral, uterine arteries, and ductus venosus were measured before and after tocolysis.
There were no differences between the groups in terms of maternal age, gestational week, body mass indexes, cervical dilation, effacement at admission, birth weights and latency periods until birth. Nifedipine decreased resistance indexes in uterine arteries but magnesium sulfate increased resistance especially in the right uterine artery. Nifedipine significantly decreased systole to diastole and resistance index in the umbilical artery, magnesium sulfate increased systole to diastole and resistance index but this was not statistically significant. Nifedipine acted variably on resistance index and pulsatility index in the ductus venosus; however, magnesium sulfate increased resistance. Nifedipine decreased pulsatility index in the middle cerebral artery, contrary to magnesium sulfate with which it increased.
Nifedipine had favorable effects on maternal and fetal vessel indexes but magnesium sulfate increased resistance. Despite the proposed neuroprotective benefits of magnesium sulfate, nifedipine seems to be a better and safer tocolytic agent than magnesium sulfate due to its positive beneficial effects on maternal and fetal vessels.
研究两种宫缩抑制剂硝苯地平与硫酸镁对母胎血管多普勒指数的影响。
我们招募了100名孕24 - 36周早产孕妇，她们在两年内被收入我们的三级医疗中心。患者被分为硝苯地平组（n = 49）和硫酸镁组（n = 51），在宫缩抑制前后测量脐动脉、大脑中动脉、子宫动脉及静脉导管的多普勒指数。
两组在产妇年龄、孕周、体重指数、宫颈扩张、入院时宫颈消退情况、出生体重及至出生的潜伏期方面无差异。硝苯地平降低子宫动脉阻力指数，而硫酸镁增加阻力，尤其是右子宫动脉。硝苯地平显著降低脐动脉的收缩期与舒张期比值及阻力指数，硫酸镁虽增加了收缩期与舒张期比值及阻力指数，但无统计学意义。硝苯地平对静脉导管的阻力指数和搏动指数作用各异；然而，硫酸镁增加了阻力。硝苯地平降低大脑中动脉的搏动指数，而硫酸镁则使其增加。
硝苯地平对母胎血管指数有良好影响，而硫酸镁增加阻力。尽管硫酸镁具有神经保护作用，但由于硝苯地平对母胎血管有积极有益影响，它似乎是比硫酸镁更好更安全的宫缩抑制剂。
