Wenstrom K D, Weiner C P, Merrill D, Niebyl J
University of Iowa, Department of Obstetrics and Gynecology, Iowa City, USA.
Am J Perinatol. 1997 Feb;14(2):87-91. doi: 10.1055/s-2007-994104.
To determine the efficacy of the terbutaline pump for the prevention of preterm delivery, patients in preterm labor defined by progressive cervical change underwent intravenous magnesium sulfate tocolysis (with or without oral indomethacin, as necessary), and once labor was arrested, were randomized to one of three treatment arms: terbutaline by pump, saline by pump (blinded), or oral terbutaline. If recurrent preterm labor occurred despite maximization of therapy, the treatment arm was determined and therapy was changed; saline pump and oral terbutaline were switched to terbutaline pump, terbutaline pump was switched to oral terbutaline. Patients who continued to labor were readmitted for aggressive intravenous therapy. Women randomized to the terbutaline pump (n = 15), saline pump (n = 12), and oral terbutaline (n = 15) groups were similar in terms of gravidity, parity, days of tocolysis before study entry, gestational age at entry, and cervical dilatation at entry. The mean gestational age at delivery was the same in all three groups (35 weeks), as were neonatal outcomes. Terbutaline by pump, saline by pump, and oral terbutaline appear equivalent for the prevention of preterm delivery. The terbutaline pump should remain experimental.
为确定特布他林泵预防早产的疗效，对因宫颈进行性改变而处于早产临产状态的患者进行静脉硫酸镁抑制宫缩治疗（必要时加用或不加用口服吲哚美辛），一旦宫缩停止，将患者随机分为三个治疗组之一：使用泵输注特布他林、使用泵输注生理盐水（设盲）或口服特布他林。如果尽管进行了最大化治疗仍发生复发性早产临产，则确定治疗组并更换治疗方法；将使用泵输注生理盐水和口服特布他林改为使用泵输注特布他林，将使用泵输注特布他林改为口服特布他林。继续临产的患者再次入院接受积极的静脉治疗。随机分为使用泵输注特布他林组（n = 15）、使用泵输注生理盐水组（n = 12）和口服特布他林组（n = 15）的女性在妊娠次数、产次、研究入组前抑制宫缩的天数、入组时的孕周以及入组时的宫颈扩张情况方面相似。三组的平均分娩孕周相同（35周），新生儿结局也相同。使用泵输注特布他林、使用泵输注生理盐水和口服特布他林在预防早产方面似乎等效。特布他林泵仍应作为实验性方法。
