Premature births: how to manage tocolysis


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Objective. To elaborate a pathogenetic approach to tocolytic therapy. Subjects and methods. A total of 146 patients with clinical presentations of preterm labor at 24 to 34 weeks’ gestation were examined. Results. In 71.9% of pregnant women, tocolysis with atosiban could prolong pregnancy for 48 hours or more. Pregnancy could be prolonged for an average of 13.1±3.5 days. Further examination revealed cervical canal infection in 71.2% of women. In addition, the study showed that the expression of toll-like receptor (TLR) in the cervical canal epithelium was enhanced in women without cervical infection. Conclusion. Our investigations have demonstrated that cyclooxygenase inhibitors should be the leading tocolytic agents and it is necessary to use antibacterial therapy to enhance the efficiency of tocolysis.

Full Text

Restricted Access

About the authors

Vera S. Belousova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: desdemosha@mal.ru
corresponding author-Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics, Gynecology and Perinatology at the Medical Faculty

Alexander N. Strizhakov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: kafedra-agp@mail.ru
Academician of the Russian Academy of Sciences, Doctor of Medical Sciences, Professor, Head of the Department of Obstetrics, Gynecology and Perinatology at the Medical Faculty

Elena Vladimirovna Timokhina

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: elena.timokhina@mail.ru
Doctor of Medical Sciences, Professor of the Department of Obstetrics, Gynecology and Perinatology at the Medical Faculty

Irina Mikhailovna Bogomazova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: irinka.bogomazova@mail.ru
Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics, Gynecology and Perinatology at the Medical Faculty

Elena Germanovna Pirskhelauri

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: elena-doc@rambler.ru
Candidate of Medical Sciences, Associate Professor of the Department of Obstetrics, Gynecology and Perinatology at the Medical Faculty

Elena Sergeevna Emelyanova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: kafedra-agp@mail.ru
a student of the medical faculty

References

  1. Mandy G.T. Incidence and mortality of preterm infant. UptoDate; 2017. Available at: https://www.uptodate.com/contents/incidence-and-mortality-of-the-preterm-infant?search=Incidence%20and%20mortality%20of%20 preterm%20infant&source=search_result&selectedTitle=1~150&usage_ type=default&display_rank=1
  2. Simhan H.N., Caritis S. Inhibition of acute preterm labor. UptoDate; 2019. Available at: https://www.uptodate.com/contents/inhibition-of-acute-preterm-labor?search=Inhibition%20of%20acute%20pre-term%20labor&source=search_result&selectedTitle=1~150&usage_ type=default&display_rank=1
  3. WHO Recommendations on interventions to improve preterm birth outcomes. World Health Organization; 2015. Available at: https://apps.who.int/iris/bit-stream/handle/10665/183037/?sequence=1
  4. Flenady V., Reinebrant H.E., Liley H.G., Tambimuttu E.G., Papatsonis D.N. Oxytocin receptor antagonists for inhibiting preterm labour. Cochrane Database Syst. Rev. 2014; (6): CD004452. https://dx.doi.org/10.1002/14651858. CD004452.pub3.
  5. American College of Obstetricians and Gynecologists Committee on Obstetric Practice Society for Maternal-Fetal Medicine. Committee Opinion No. 573: Magnesium sulfate use in obstetrics. Obstet. Gynecol. 2013; 122(3): 727-8. https://dx.doi.org/10.1097/01.AOG. 0000433994.46087.85.
  6. Crowther C.A., Brown J., McKinlay C.J., Middleton P. Magnesium sulphate for preventing preterm birth in threatened preterm labour. Cochrane Database Syst. Rev. 2014; (8): CD001060. https://dx.doi.org/10.1002/14651858. CD001060.pub2.
  7. Yallampalli C., Dong Y.L., Gangula P.R., Fang L. Role and regulation of nitric oxide in the uterus during pregnancy and parturition. J. Soc. Gynecol. Investig. 1998; 5(2): 58-67. https://dx.doi.org/10.1016/ S1071-5576(97)00106-8.
  8. Smith G.N., Walker M.C., McGrath M.J. Randomised, double-blind, placebo controlled pilot study assessing nitroglycerin as a tocolytic. Br. J. Obstet. Gynaecol. 1999; 106(7): 736-9.
  9. Lees C.C., Lojacono A., Thompson C., Danti L., Black R.S., Tanzi P. et al. Glyceryl trinitrate and ritodrine in tocolysis: an international multicenter randomized study. GTN Preterm Labour Investigation Group. Obstet. Gynecol. 1999; 94(3): 403-8.
  10. Баев О.Р., Васильченко О.Н., Карапетян А.О., Тетруашвили Н.К., Ходжаева З.С. Сравнение токолиза нифедипином и атозибаном при преждевременных родах. Акушерство и гинекология. 2018; 5: 50-6. https:// dx.doi.org/10.18565/aig.2018.5.50-5
  11. Баев О.Р., Васильченко О.Н., Карапетян А.О., Тетруашвили Н.К., Ходжаева З.С. Сравнение токолиза гексопреналином и атозибаном. Медицинский совет. 2017; 2: 57-61.
  12. Romero R., Miranda J., Chaiworapongsa T., Korzeniewski S.J., Chaemsaithong P., Gotsch F. et al. Prevalence and clinical significance of sterile intra-amniotic inflammation in patients with preterm labor and intact membranes. Am. J. Reprod. Immunol. 2014; 72(5): 458-74. https://dx.doi.org/10.1111/aji.12296.
  13. Feldman N., Rotter-Maskowitz A., Okun E. DAMPs as mediators of sterile inflammation in aging-related pathologies. Ageing Res. Rev. 2015; 24(Pt A): 29-39. https://dx.doi.org/10.1016/j.arr.2015.01.003.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2019 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies