Goodwin T M, Valenzuela G, Silver H, Hayashi R, Creasy G W, Lane R
University of Southern California, USA.
Am J Perinatol. 1996 Apr;13(3):143-6. doi: 10.1055/s-2007-994312.
The purpose of this study was to describe the course of preterm labor in patients receiving a standard intravenous infusion of the oxytocin antagonist atosiban. An open-labeled, non-randomized study was conducted at 4 sites. Successful tocolysis was defined as delay of delivery larger than 48 hours from starting atosiban and no need for an alternate tocolytic. Atosiban was administered by continuous intravenous infusion at a rate of 300 micrograms per minute until uterine contractions were absent for 6 hours, or up to a maximum infusion time of 12 hours. Sixty-two patients of between 20 and 36 weeks' gestation were enrolled over 6 months. One had rupture of membranes and was excluded. Successful tocolysis was noted in 43 of 61 (70.5%). Four delivered spontaneously within 48 hours and 14 (23.0%) required an alternate tocolytic agent. The chance of successful tocolysis was related to the degree of cervical dilation at the start of therapy. Cessation of uterine contractions was noted in 38 patients (62.3%). A decrease in uterine contraction frequency of 50% or more was noted in 50 of 61 patients (82.0%). Four patients reported side effects (nausea, vomiting, headache, dysguesia, chest pain), but in no case did side effects require discontinuation of the medication. Intravenous administration of atosiban is associated with a delay in delivery comparable to that seen with other tocolytics. If this effect is confirmed in planned placebo-controlled trials, its favorable side effect profile may give it a place in the armamentarium.
本研究的目的是描述接受标准静脉输注催产素拮抗剂阿托西班的早产患者的病程。在4个地点进行了一项开放标签、非随机的研究。成功的宫缩抑制定义为从开始使用阿托西班起分娩延迟超过48小时且无需使用其他宫缩抑制剂。阿托西班以每分钟300微克的速度持续静脉输注，直至子宫收缩停止6小时，或最长输注时间达12小时。在6个月内纳入了62例妊娠20至36周的患者。其中1例发生胎膜破裂，被排除在外。61例患者中有43例（70.5%）实现了成功的宫缩抑制。4例在48小时内自然分娩，14例（23.0%）需要使用其他宫缩抑制剂。成功宫缩抑制的几率与治疗开始时的宫颈扩张程度有关。38例患者（62.3%）出现子宫收缩停止。61例患者中有50例（82.0%）子宫收缩频率降低了50%或更多。4例患者报告了副作用（恶心、呕吐、头痛、味觉障碍、胸痛），但无一例因副作用而停药。静脉注射阿托西班与其他宫缩抑制剂一样，可延迟分娩。如果在计划中的安慰剂对照试验中证实了这种效果，其良好的副作用特征可能使其在药物治疗中占有一席之地。
