利托君用于外倒转术：其有效性和安全性如何？
Ritodrine in external cephalic version: is it effective and safe?
作者信息
Kim Sin Ae, Cha Eun-Hwan, Chun Kyoung-Chul, Kim Young Ah, Koh Jae-Whoan, Han Jung Yeol, Hwang Jong Hee
机构信息
Department of Obstetrics and Gynecology, Inje University Ilsan Paik Hospital, Seoul, Korea.
Korean Mothersafe Counselling Center, Pregnancy & Breastfeeding Medicines Information Center, Seoul, Korea.
出版信息
Obstet Gynecol Sci. 2022 Sep;65(5):420-429. doi: 10.5468/ogs.22106. Epub 2022 Jul 29.
OBJECTIVE
The external cephalic version (ECV) has been shown to lower the likelihood of cesarean section requirements among pregnant women with breech presentations. In the current study, we investigated the effectiveness and safety of ritodrine as a tocolytic for ECV.
METHODS
A total of 407 pregnant women with breech presentations, who had no contraindications for ECV, were enrolled in this study. Multivariable logistic regression analyses were used to assess the impact of ritodrine use on the safety and efficacy of ECV.
RESULTS
The overall success rate was 67.6%, and ritodrine use was associated with significantly higher odds of successful ECV after adjusting for confounders. Moreover, using ritodrine did not increase the risk of adverse effects, including temporary changes in fetal heart rate, need for elective or emergency cesarean section due to fetal distress during ECV, low Apgar scores, and perinatal mortality.
CONCLUSION
Our results suggest that using ritodrine as a tocolytic during ECV may increase the likelihood of ECV success and may not increase adverse perinatal outcomes.
目的
外倒转术（ECV）已被证明可降低臀位孕妇剖宫产的可能性。在本研究中，我们调查了利托君作为ECV宫缩抑制剂的有效性和安全性。
方法
本研究共纳入407例无ECV禁忌证的臀位孕妇。采用多变量逻辑回归分析评估使用利托君对ECV安全性和有效性的影响。
结果
总体成功率为67.6%，在对混杂因素进行校正后，使用利托君与ECV成功几率显著升高相关。此外，使用利托君并未增加不良反应风险，包括胎儿心率的暂时变化、因ECV期间胎儿窘迫而行择期或急诊剖宫产的需求、阿氏评分低以及围产期死亡率。
结论
我们的结果表明，在ECV期间使用利托君作为宫缩抑制剂可能会增加ECV成功的可能性，且可能不会增加不良围产期结局。
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