A PEER-REVIEWED JOURNAL OF RESEARCH AND CLINICAL MEDICINEISSN 1727-2378 (Print)         ISSN 2713-2994 (Online)
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Improving Perinatal Outcomes in Women with Preterm Labor

For citation: Rybalka A. N., Ziyadinov Ar. A., Sulima A. N., Ziyadinov Al. A. Improving Perinatal Outcomes in Women with Preterm Labor. Doctor.Ru. 2017; 9(138): 44–47.

Study Objective: To improve perinatal outcomes in women with preterm labor (PL).

Study Design: This was a prospective, randomized, cohort study.

Materials and Methods: The study included 355 pregnant women with threatened PL (more than four uterine contractions in a 30-minute period and shortening of the cervix of less than 30 mm) who were given a tocolytic agent. They were randomized to receive either the oxytocin receptor antagonist atosiban (n = 107) or the β2 adrenergic receptor agonist hexoprenaline sulfate (n = 248). The patients’ condition was monitored by analyzing cardiotocography parameters and dynamic changes in cervical length, as assessed by ultrasound.

Statistical analysis was performed using Statistica for Windows v. 7.0 from StatSoft Inc. (USA). Quantitative data were assessed using variance analysis. The χ2 test and the Student t-test were used to compare parameters and detect differences between independent samples. Parameter differences of p < 0.05 were defined as statistically significant.

Study Results: In women who received atosiban to suppress labor side effects were less frequent by a factor of 9.6 (p < 0.05) and the frequency at which the pregnancy was prolonged by more than seven days was 1.3 times higher (59.8% vs. 47.2%, p < 0.05) than in women who were treated with hexoprenaline sulfate. After seven days the mean cervical length was 14.6 ± 1.2 mm in the atosiban group and 11.2 ± 1.4 mm in the hexoprenaline sulfate group (p < 0.01). In 3.7% of the women in the atosiban group and 14.9% of the women in the hexoprenaline sulfate group (p < 0.01), therapy to suppress labor was stopped due to side effects.

There was no significant difference between women treated with atosiban and with hexoprenaline sulfate in either delivery term (35.8 ± 0.4 weeks vs. 34.9 ± 0.3 weeks, р > 0.05) or the babies’ weight at birth (2,643.5 ± 154.8 g vs. 2,586.3 ± 147.4 g, р > 0.05). Nonetheless, in the atosiban group hypoxia/asphyxia during labor was less frequent by a factor of 5.2 (1.9% vs. 9.8%, p < 0.05), respiratory distress syndrome in the newborns was less frequent by a factor of 1.6 (p < 0.05), and perinatal mortality was lower by a factor of 1.7 (9.3‰ vs. 16.1‰, р < 0.05).

Conclusion: In women with threatened PL, labor suppression using the oxytocin receptor antagonist atosiban, coupled with cardiotocography and ultrasound assessment of dynamic changes in cervical length, has a number of advantages compared to the use of the β2 adrenergic receptor agonist hexoprenaline sulfate. Introducing tocolytic treatment with atosiban into clinical practice reduces the frequency of side effects by a factor of 9.6 (р < 0.05) and quadruples compliance with tocolytic therapy (р < 0.05). It is also more effective in prolonging pregnancies by more than seven days, and in reducing both the frequency of respiratory disorders in newborns and perinatal mortality.

A. N. Rybalka — S. I. Georgievsky Medical Academy at the V. I. Vernadsky Crimea Federal University, Simferopol. E-mail: RAA1939@yandex.ru

Ar. A. Ziyadinov — S. I. Georgievsky Medical Academy at the V. I. Vernadsky Crimea Federal University, Simferopol. E-mail: ars-en@yandex.ru

A. N. Sulima — S. I. Georgievsky Medical Academy at the V. I. Vernadsky Crimea Federal University, Simferopol. E-mail: gsulima@yandex.ua

Al. A. Ziyadinov — S. I. Georgievsky Medical Academy at the V. I. Vernadsky Crimea Federal University, Simferopol. E-mail: aalii@yandex.ua


Доктор.ру
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