Higby K, Xenakis E M, Pauerstein C J
Department of Obstetrics and Gynecology, University of Texas Health Science Center, San Antonio 78284.
Am J Obstet Gynecol. 1993 Apr;168(4):1247-56; discussion 1256-9. doi: 10.1016/0002-9378(93)90376-t.
Our aim was to determine the efficacy and safety of tocolytic agents currently used to treat premature labor.
We carried out a comprehensive review of tocolytic agents in the treatment of premature labor. Three hundred twenty-eight studies published between 1933 and 1992 were analyzed.
An analysis of randomized, placebo-controlled, clinical trials showed that magnesium sulfate is not better than placebo in the treatment of premature labor. beta-Adrenergic receptor agonists effectively stop premature labor for only 24 to 48 hours. Calcium channel blockers and oxytocin antagonists inhibit uterine contractions, but their role in stopping labor is undefined. Prostaglandin inhibitors appear to be effective in treating premature labor and have few adverse side effects.
The only tocolytic drugs that might be effective are the prostaglandin inhibitors. Tocolytic agents should be used only between 24 and 32 completed weeks of gestation. Magnesium sulfate should not be used to treat premature labor. Oxytocin antagonists should be used only in experimental clinical trials. Calcium channel blockers and beta-adrenergic receptor agonists inhibit uterine contractions but do not prolong gestation for longer than 48 hours.
我们的目的是确定当前用于治疗早产的宫缩抑制剂的疗效和安全性。
我们对宫缩抑制剂治疗早产进行了全面综述。分析了1933年至1992年间发表的328项研究。
对随机、安慰剂对照临床试验的分析表明，硫酸镁在治疗早产方面并不优于安慰剂。β-肾上腺素能受体激动剂仅能有效抑制早产24至48小时。钙通道阻滞剂和催产素拮抗剂可抑制子宫收缩，但其在阻止分娩中的作用尚不明确。前列腺素抑制剂似乎对治疗早产有效且副作用较少。
唯一可能有效的宫缩抑制剂是前列腺素抑制剂。宫缩抑制剂仅应在妊娠满24至32周之间使用。硫酸镁不应被用于治疗早产。催产素拮抗剂仅应在临床试验中使用。钙通道阻滞剂和β-肾上腺素能受体激动剂可抑制子宫收缩，但不会使妊娠期延长超过48小时。
