| Objective:By the retrospective analysis, to summary the related factors of premature, and compare spuc effect, adverse reaction and neonatal prognosis of magnesium sulfate and ritodrine hydrochloride in the prevention and treatment of preterm labor, to provide the basis for clinical treatment of precursor premature medication.Methods:175 gravidas with the diagnoses of threatened premature labor in the outpatient department and then were admitted to the hospital for tocolysis were included in the study from Jun 2010 to Dec 2015 in the obstetrical department of the second affiliated hospital of chongqing medical university, Inclusion criteria as follows:(1)Irregular contractions or rules, abdominal pain, abdominal distention, lumbosacral region pain and straining feeling,vaginal bleeding, without cervical expansion;(2)Eliminate premature labor and physiologic contractions;(3)The blood and urine routine, biochemical and liver function, electrolyte, blood sugar,electrocardiogram, cardiac care, and ultrasonic were all withoutexception;(4)There was no use contraindication of ritodrine hydrochloride or magnesium sulfate such as diabetes, hyperthyroidism, heart disease, high blood pressure, or anemia;(5) No pregnancy contraindicated.According to the drug into the magnesium sulfate group,the ritodrine hydrochloride group and the alternating group. Using SPSS 20.0 statistical software to analyze that pregnant women generally(age,maternal history,histories of abnormal pregnancy and preterm birth), uterine contractions and vaginal bleeding,complications,gestational age, extend the days of pregnancy, spuc efficiently, adverse reaction, neonatal birth weight, and Apgar score,respiratory distress syndrome(RDS).The quantitative data was expressed as( x ±s),with the analysis method of variance(ANOVA),and count data was expressed as(percentage),with the analysis method of χ2 test and Fisher’s exact test.The significant difference id showed with P<0.05.Results:(1)The average age was 29.21 ± 4.70 years of age,gestational age was from 28 to 36+2 weeks,the average gestational age was32.86±2.59 weeks.The times of pregnancy:only once:69 gravidas, twice:47gravidas, three times: 30 gravidas, four or more than four times: 29 gravidas. There were 138 primiparas and 37 multiparas in this analysis.Differences between the three groups of pregnant women in the age structure and gestational age were not statistically significant(P>0.05),clinical data comparable.(2)The incentives of preterm labor include premature rupture of membranes(44.6%), placenta factor(22.2%),abnormal position(15.4%), multiplets(13.7%), infection factors(16%),cervical lesions(2.3%), uterine malformation(2.3%), having a history of spontaneous abortion(12%) and other complications(surgical diseases and conception of assisted reproductive technology).(3)The ritodrine hydrochloride group was better than magnesium sulfate group and alternating group in prolong the gestational age(P<0.05). Magnesium sulfate group and alternating group was no significant difference(P>0.05).Spuc efficient:Results no significant difference between three groups of drugs(P>0.05).(4)Neonatal birth weight: Magnesium sulfate respectively with ritodrine hydrochloride group and alternating group had no significant difference(P>0.05). The ritodrine hydrochloride group was obviously better than alternating group in neonatal birth weight(P<0.05).(5)Differences between the three groups in the neonatal Apgar score 1minute and 5 minute were not statistically significant(P>0.05).(6)Differences between the three groups in the incidence of neonatal respiratory distress syndrome were not statistically significant(P>0.05).(7)Adverse reactions: the ritodrine hydrochloride group: a total of 43 cases,accounted for 53.09%, magnesium sulfate group: a total of 9 cases,accounted for 18%, alternating group: a total of 26 patients, accounted for59.09%, the magnesium sulfate group was obviously less than another groups(P<0.05); the ritodrine hydrochloride group and alternating group had no significant difference(P>0.05).Conclusions:(1)The etiology of premature labor is the outcome of combined action of multiple factors, estimating the risk and giving symptomatic supportive treatment are critical.(2)For treating those patients without hypertension disease or use contraindications of ritodrine hydrochloride,now commonly use ritodrine hydrochloride to inhibit contractions.(3)The magnesium sulfate group was worse than ritodrine hydrochloride group in prolong the gestational age,but the adverse reaction was relatively small,and did not increase the incidence of neonatal prognosis.So magnesium sulfate can be used in clinical prevention and treatment of premature birth routinely, especially in patients with gestational hypertension combined preterm birth. |
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