Clinical Analysis Of Three Kinds Of Tocolytic Agents In The Treatment Of Advanced Threatened Abortion And Threatened Preterm Labor

Objective: To investigate the clinical effects of ritodrine,atosiban and magnesium sulfate in the treatment of advanced threatened abortion and threatened premature delivery.Methods: The clinical data of 71 patients with advanced threatened abortion and threatened preterm labor who were treated in the First Affiliated Hospital of Fujian Medical University were collected from September 2017 to December 2018.In the 71 cases,45 pregnant women were treated with magnesium sulfate to protect fetal brain nerve,38 with ritodrine inhibiting uterine contraction,and 67 with atosiban.According to the different treatment plans,71 cases were divided into: Ritojun group(A1 group,n=38),Atosiban group(A2 group,n=23),and magnesium sulfate group(A3 group,n= 45);Ritojun alone group(B1 group,n=27),Atosiban sequential Ritojun group(B2 group,n=10),and Atosiban alone group(B3 group,n=6).Observe the gestational age at the time of medication,the success rate of complete inhibition of uterine contraction(or vaginal bleeding stop)in 48 hours after taking the medication.Observe the success rate of complete inhibition of uterine contraction(or vaginal bleeding stop)in 48 hours in the cases with different lengths of the cervical canal(CL ? 15 mm and CL < 15 mm)after taking the medication,prolonged gestation days,gestational week at birth,neonatal Apgar score,neonatal birth weight and adverse drug reactions.Statistical methods were drawn using Excel2003,and statistical data were expressed using mean,percentage,and standard deviation.?2 test,Fisher's exact probability test,t test and one-way ANOVA were performed using SPSS21.0 software.P<0.05 indicated that the difference was statistically significant.result: 1.There was no significant difference between the success rate of complete inhibition of uterine contraction(or vaginal bleeding stop)in 48 hours after taking the medication between the Ritojun group and the Atosiban group(P=1.00>0.05).The success rate of complete inhibition of uterine contraction(or vaginal bleeding stop)in 48 hours of the Ritojun group was statistically significant compared with the magnesium sulfate group(P= 0.002<0.05);the success rate of complete inhibition of uterine contraction(or vaginal bleeding stop)in 48 hours in the Atosiban group was significantly different from that of magnesium sulfate group(P=0.004<0.05).2.There was a statistically significant difference in the prolonged gestational age between the Ritojun alone group and the Atosiban sequential Ritojun group(P=0.020<0.05);There was a statistically significant difference in the prolonged gestational age between the Atosiban alone group and the Atosiban sequential Ritojun group(P=0.006<0.05).There was no significant difference in the prolonged gestational age between the ritodrine alone group and the atosiban alone group(P =0.555>0.05).3.The incidence of drug side effects in the Ritojun group was significantly different from that in the atosiban group(P=0.002<0.05).The incidence of drug side effects in the Ritojun group was statistically significant compared with the magnesium sulfate group(P=0.000<0.05);There was no significant difference in the incidence of drug side effects between the atosiban group and the magnesium sulfate group(P=1.000>0.05).4.There was no significant difference in the birth weight of newborns between Ritojun alone group and Atosiban sequential Ritojun group(P=0.080>0.05);There was no significant difference in the birth weight of the newborns between the Atosiban alone group and the Atosiban sequential Ritojun group(P=0.548>0.05).There was no significant difference in birth weight between the ritodrine alone group and the atosiban alone group(P=0.932>0.05).5.There was no statistically significant difference in neonatal Apgar scores between the Ritojun alone group,the Atosiban sequential Ritojun group,and the Atosiban alone group(P=1.000>0.05).6.The success rate of complete inhibition of uterine contraction(or vaginal bleeding stop)in 48 hours after taking the medication in the Ritojun CL?15mm group was significantly better than the Ritojun CL<15mm group(P=0.047<0.05);the success rate of complete inhibition of uterine contraction(or vaginal bleeding stop)in 48 hours in the Atosiban CL?15mm group was significantly better than the Atosiban CL<15 mm group(P=0.045<0.05).Conclusion: 1.There is no significant difference in the success rate of complete inhibition of uterine contraction(or vaginal bleeding stop)in 48 hours after taking the medication between Litojun and Atosiban,but the success rate of Litojun and Atosiban is significantly better than that of magnesium sulfate.2.The incidence of drug side effects of atosiban,and magnesium sulfate is low,and the incidence of adverse reactions of ritodrine is high,pregnant women who used ritojun finally reduced the medication or changed to use other medications mostly due to inability to tolerate drug side effects.3.Ritojun sequential atosiban used to treat advanced threatened abortion and threatened preterm labor is better than use the ritodrine alone or use the atosiban alone in extending gestational age,which is important to improve the quality of life and survival of the fetus.4.whether using atosiban or using ritojun for treatment,the success rate of complete inhibition of contraction in 48 h after taking the medication of CL?15mm group was significantly better than that of CL<15mm group.cervical canal length is also an important indicator of the efficacy of uterine contraction inhibitor.5.whether using the Ritojun alone or using the atosiban alone or using Ritojun sequential atosiban for treatment,the neonatal birth weight and neonatal Apgar score both had no significant difference.