Caritis S N
Drugs. 1983 Sep;26(3):243-61. doi: 10.2165/00003495-198326030-00005.
Preterm delivery accounts for a major proportion of perinatal deaths. The cause of preterm labour is usually not known, but in most instances, maintaining the fetus in utero appears to be preferred to allowing preterm delivery. Numerous pharmacological agents have been utilised to inhibit preterm labour, but none has proven to be ideal. Currently, the beta-adrenoceptor stimulants such as ritodrine, terbutaline, isoxsuprine, salbutamol and fenoterol provide the best combination of safety and efficacy. However, because of their potential adverse effects, adequate maternal and fetal surveillance needs to be maintained throughout their administration. Magnesium sulphate, although probably not as effective as other labour-inhibiting drugs, is an appropriate choice when the beta-adrenoceptor stimulants are either contraindicated or poorly tolerated. Other drugs such as the prostaglandin inhibitors, diazoxide or the calcium antagonists are also potent labour-inhibitors, but further controlled studies are required to evaluate the risks associated with their use. Ethanol has been supplanted by the beta-adrenoceptor stimulants and is unlikely to be used in the future.
早产占围产期死亡的很大比例。早产的原因通常不明，但在大多数情况下，让胎儿留在子宫内似乎比早产更可取。许多药物已被用于抑制早产，但没有一种被证明是理想的。目前，诸如利托君、特布他林、异克舒令、沙丁胺醇和非诺特罗等β-肾上腺素能受体激动剂提供了安全性和有效性的最佳组合。然而，由于它们潜在的不良反应，在整个用药过程中需要对母婴进行充分监测。硫酸镁虽然可能不如其他抑制宫缩的药物有效，但当β-肾上腺素能受体激动剂禁忌或耐受性差时，是一个合适的选择。其他药物如前列腺素抑制剂、二氮嗪或钙拮抗剂也是有效的宫缩抑制剂，但需要进一步的对照研究来评估与它们使用相关的风险。乙醇已被β-肾上腺素能受体激动剂所取代，未来不太可能再使用。
