المؤلفون: Gonçalves, Joana L.¹ joanaglopes@gmail.com, Fuertes, Marina¹, Alves, Maria João¹, Antunes, Sandra², Almeida, Ana Rita³, Casimiro, Rute³, Santos, Margarida^2,4

المصدر: BMC Pregnancy & Childbirth. 5/6/2020, Vol. 20 Issue 1, p1-16. 16p.

مصطلحات موضوعية: *PREMATURE labor, *PREMATURE infants, *MOTHER-infant relationship, *MATERNAL health services, *CHILDBIRTH, *POSTPARTUM depression, *PREGNANCY, *NEONATAL intensive care, *PSYCHOLOGY of mothers, *GESTATIONAL age, *NEONATAL intensive care units, *RESEARCH funding, *LABOR (Obstetrics), *MOTHER-child relationship

مستخلص: Background: Mothers' reports about pregnancy, maternity and their experiences during the perinatal period have been associated with infants' later quality of attachment and development. Yet, there has been little research with mothers of very preterm newborns. This study aimed to explore mothers' experiences related to pregnancy, premature birth, relationship with the newborn, and future perspectives, and to compare them in the context of distinct infants' at-birth-risk conditions.Methods: A semi-structured interview was conducted with women after birth, within the first 72 h of the newborn's life. A total of 150 women participated and were divided in three groups: (1) 50 mothers of full-term newborns (Gestational Age (GA) ≥ 37 weeks; FT), (2) 50 mothers of preterm newborns (GA 32-36 weeks; PT) and (3) 50 mothers of very preterm newborns (GA < 32 weeks; VPT).Results: Mothers of full-term infants responded more often that their children were calm and that they did not expect difficulties in taking care of and providing for the baby. Mothers of preterm newborns although having planned and accepted well the pregnancy (with no mixed or ambivalent feelings about it) and while being optimistic about their competence to take care of the baby, mentioned feeling frightened because of the unexpected occurrence of a premature birth and its associated risks. Mothers of very preterm newborns reported more negative and distressful feelings while showing more difficulties in anticipating the experience of caring for their babies.Conclusion: The results indicate that Health Care Systems and Neonatal Care Policy should provide differentiated psychological support and responses to mothers, babies and families, taking into account the newborns' GA and neonatal risk factors. [ABSTRACT FROM AUTHOR]

المؤلفون: Pradhan, Dinesh¹ (AUTHOR) dinesh.bhutan@gmail.com, Nishizawa, Yoriko¹ (AUTHOR), Chhetri, Hari P² (AUTHOR)

المصدر: Journal of Tropical Pediatrics. Apr2020, Vol. 66 Issue 2, p163-170. 8p.

مصطلحات موضوعية: *PREMATURE labor, *PREMATURE infants, *NEONATAL mortality, *CHILDBIRTH, *BIRTH rate, *PUBLIC hospitals, *CESAREAN section, *RESEARCH, *NEONATAL intensive care, *NEONATAL diseases, *RESEARCH methodology, *NEONATAL intensive care units, *FETAL growth retardation, *DISEASES, *EVALUATION research, *MEDICAL cooperation, *COMPARATIVE studies, *PREGNANCY complications, *MEDICAL referrals, *DISEASE prevalence, *INFANT mortality, *SMALL for gestational age

مصطلحات جغرافية: BHUTAN

مستخلص: Introduction: Preterm birth-related complications are the leading cause of under-5 mortality globally. Bhutan does not have a reliable preterm birth rate or data regarding outcome of preterm babies.Aim: To determine the preterm birth rate at the Jigme Dorji Wangchuck National Referral Hospital (JDWNRH) in Thimphu, Bhutan, and assess their outcomes.Methods: All live preterm births at JDWNRH from 1 January 2017 to 31 December 2017 were followed from birth till hospital discharge. Maternal demographic data, pregnancy details and delivery details were collected. Morbidity and mortality information as well as discharge outcome were collected on babies admitted to neonatal intensive care unit (NICU).Results: Preterm birth rate among live births was 6.4%. Most mothers were younger than 30 years, housewives and had secondary education. Pregnancy registration rate and adequacy of antenatal visits were high. Most preterm births were singleton and the predominant mode of delivery was cesarean section. More than half of the births were initiated spontaneously, and the male:female ratio was 1.2:1. Most babies were late preterm and low birth weight. Half of them required NICU admission. Overall mortality rate was 11% and 21.6% for admitted preterm neonates. Preterm small-for-gestational-age neonates, and those born after provider-initiated preterm birth had significantly increased risk of mortality. Most preterm neonates were discharged without complications. The rate of extrauterine growth restriction was high.Conclusion: This is the first study on the prevalence of preterm births and their outcomes in the largest tertiary-care hospital in Bhutan. [ABSTRACT FROM AUTHOR]

المؤلفون: Zgutka, Kinga, Prasanth, Kaninghat, Pinero-Bernardo, Shirley, Lew, Lily Q., Cervellione, Kelly, Rhythm, Rhythm, Rahman, Lubna, Dolmaian, Gigliola, Cohen, Lourdes

المصدر: Journal of Perinatal Medicine; Jul2021, Vol. 49 Issue 6, p691-696, 6p

مصطلحات موضوعية: HOSPITALS, CHILDBIRTH, LENGTH of stay in hospitals, COVID-19, NEONATAL intensive care, PREGNANT women, CASE-control method, NEONATAL intensive care units, PREGNANCY outcomes, BIRTH weight, VERTICAL transmission (Communicable diseases), PREMATURE labor, PREGNANCY

مصطلحات جغرافية: NEW York (State)

مستخلص: To compare clinical characteristics and outcomes of infants born to COVID-19 to non COVID-19 mothers at delivery in a community hospital in Queens, New York. Case-control study conducted March 15 to June 15, 2020. Cases were infants born to mothers with laboratory-confirmed COVID-19 infection at delivery. The infant of non COVID-19 mother born before and after each case were selected as controls. Of 695 deliveries, 62 (8.9%) infants were born to COVID-19 mothers; 124 controls were selected. Among cases, 18.3% were preterm compared to 8.1% in controls (p=0.04). In preterm cases, birth weight was not significantly different between groups. However, there was a significantly higher proportion of neonatal intensive care unit (NICU) admissions, need for respiratory support, suspected sepsis, hyperbilirubinemia, feeding intolerance and longer length of stay (LOS) in preterm cases. Among term cases, birth weight and adverse outcomes were not significantly different between cases and controls except for more feeding intolerance in cases. All infants born to COVID-19 mothers were COVID-19 negative at 24 and 48 h of life. No infants expired during birth hospitalization. Significantly, more infants of COVID-19 mothers were premature compared to controls. Preterm cases were more likely to have adverse outcomes despite having similar birth weight and gestational age. These differences were not seen among full term infants. Health care providers should anticipate the need for NICU care when a COVID-19 mother presents in labor. [ABSTRACT FROM AUTHOR]

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المؤلفون: Berezowsky, Alexandra¹ (AUTHOR), Mazkereth, Ram² (AUTHOR), Ashwal, Eran¹ (AUTHOR), Mazaki-Tovi, Shali¹ (AUTHOR), Schiff, Eyal¹ (AUTHOR), Weisz, Boaz¹ (AUTHOR), Lipitz, Shlomo¹ (AUTHOR), Yinon, Yoav¹ (AUTHOR) yoav.yinon27@gmail.com

المصدر: Journal of Maternal-Fetal & Neonatal Medicine. Apr2016, Vol. 29 Issue 8, p1252-1256. 5p.

مصطلحات موضوعية: *TWINS, *RISK factors in premature labor, *DELIVERY (Obstetrics), *CHILDBIRTH, *DURATION of pregnancy, *GESTATIONAL age, *HOSPITAL admission & discharge, *HYPOTHERMIA, *PREMATURE infants, *NEONATAL jaundice, *LONGITUDINAL method, *MULTIPLE pregnancy, *NEONATAL intensive care, *OXYGEN therapy, *PATIENTS, *PHOTOTHERAPY, *RESPIRATORY distress syndrome, *NEONATAL intensive care units, *RETROSPECTIVE studies

مصطلحات جغرافية: ISRAEL

مستخلص: Objective: To determine the neonatal outcome at late prematurity of uncomplicated monochorionic (MC) twin pregnancies.Methods: A retrospective cohort study of 166 patients with uncomplicated MC diamniotic twins delivered between 34 and 37 weeks of gestation at a single tertiary center. The study population was classified into four groups according to the gestational age at delivery: (1) 34 weeks, (2) 35 weeks, (3) 36 weeks and (4) 37 weeks. Neonatal outcome measures were compared between the groups.Results: Neonatal morbidity was significantly higher at 34 weeks of gestation compared to the other three groups including respiratory distress syndrome, oxygen requirement, hypothermia and hyperbilirubinemia. Moreover, the rate of admission to the special care unit and need for phototherapy were significantly higher in newborns born at 36 weeks compared to 37 weeks of gestation (p = 0.02 and 0.03 respectively). Multiple regression analysis revealed that the risk for adverse neonatal outcome was significantly associated with gestational age at delivery. Of note, there were no fetal or neonatal deaths in our cohort.Conclusions: The risk of neonatal morbidity of uncomplicated MC twins delivered at 34-37 weeks of gestation significantly decreases with advanced gestation. Therefore, under close fetal surveillance, uncomplicated MC twin pregnancies should be delivered at 37 weeks of gestation. [ABSTRACT FROM AUTHOR]

المؤلفون: Washio, Yukiko, Goldstein, Neal D., Butler, Richard, Rogers, Stephanie, Paul, David A., Terplan, Mishka, Hoffman, Matthew K.

المصدر: Clinical Ethics; Sep2018, Vol. 13 Issue 3, p137-142, 6p, 2 Charts, 1 Graph

مصطلحات موضوعية: SUBSTANCE abuse in pregnancy, CHILDBIRTH, PREMATURE labor, LOW birth weight, NEONATAL intensive care, SMOKING, PREGNANCY, DRUGS of abuse

مستخلص: Objectives The purpose of the current study was to examine whether a self-report measure identifies prenatal substance use and predicts resulting adverse birth outcomes in a large cohort using electronic medical records. Methods Pregnant patients who were admitted between 2014 and 2015 at Christiana Care Health System and delivered singleton birth were included in the analyses (N = 11,020). Participant demographic information, pregnancy comorbidities, self-reported substance use, and birth outcomes were retrieved from electronic medical records. Detailed descriptive analyses of prenatal substance use were conducted, and logistic models were evaluated for the associations between substance use and each birth outcome (preterm birth, low birth weight, neonatal intensive care unit admission). Results The average maternal age was 30 years (standard deviation: 6), 37% receiving Medicaid. Over 58% were White, 26% were Black, and 13% were Hispanic. Cigarette smoking only showed the highest prevalence among substance users (53%). Self-reported cigarette smoking and illicit drug use other than marijuana significantly predicted all three adverse birth outcomes (Adjusted Odds Ratio [AOR] range: 1.33 (95% Confidence Interval [CI]: 1.08–1.64)–3.09 (95% CI: 2.03–4.67)). Nonresponders to the cigarette smoking question also significantly predicted two adverse birth outcomes of preterm birth delivery (AOR: 4.16; 95% CI: 1.27–14.71) and having low birth weight babies (AOR: 3.50; 95% CI: 1.04–12.61). Conclusions/Importance: Prenatal cigarette smoking only had the highest prevalence, and co-use with illicit drugs was also high, leading to significant associations with adverse birth outcomes. The study findings indicate that the self-report measurement is a useful tool to identify prenatal substance use and predict resulting adverse birth outcomes. [ABSTRACT FROM AUTHOR]

: Copyright of Clinical Ethics is the property of Sage Publications, Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

العنوان البديل: Very premature births: Dilemmas and management. Second part: Ethical aspects and recommendations

المؤلفون: Moriette, G.¹ guy.moriette@cch.aphp.fr, Rameix, S.², Azria, E.³, Fournié, A.⁴, Andrini, P.⁵, Caeymaex, L.^1,6, Dageville, C.⁷, Gold, F.⁸, Kuhn, P.⁹, Storme, L.¹⁰, Siméoni, U.¹¹

المصدر: Archives de Pédiatrie. May2010, Vol. 17 Issue 5, p527-539. 13p.

مصطلحات موضوعية: *PREMATURE labor, *CHILDBIRTH, *CRITICAL care medicine, *PAIN management, *NEONATAL intensive care, *GESTATIONAL age, *RESUSCITATION

مصطلحات جغرافية: FRANCE

الملخص (بالإنجليزية): Summary: In the first part of this work, the outcome following very premature birth was assessed. This enabled a gray zone to be defined, with inherent major prognostic uncertainty. In France today, the gray zone corresponds to deliveries occurring at 24 and 25 weeks of postmenstrual age. The management of births occurring below and above the gray zone was described. Withholding intensive care at birth for babies born below or within the gray zone does not mean withholding care but rather providing palliative care to prevent pain and suffering during the time period preceding death. Given the high level of uncertainty, making good decisions within the gray zone is problematic. Decisions should be based on the infant''s best interests. Decisions should be reached with the parents, who are entitled to receive clear and comprehensive information. Possible decisions to withhold intensive care should be made following the procedures described in the French law of April 2005. Guidelines, based on gestational age and the other prognostic elements, are proposed to the parents before birth. They are applied in an individualized fashion, in order to take into account the individual features of each case. At 25 weeks, resuscitation and/or full intensive care are usually proposed, unless unfavorable factors, such as severe growth restriction, are associated. A senior neonatologist will attend the delivery and will make decisions based on both the baby''s condition at birth and the parents’ wishes. At 24 weeks, in the absence of unfavorable associated factors, the parents’ wishes should be followed in deciding between initiating full intensive care or palliative care. Below 24 weeks, palliative care is the only option to be offered in France at the present time. [Copyright &y& Elsevier]

Abstract (French): Résumé: Le pronostic des naissances les plus prématurées a été envisagé dans la 1re partie de ce travail. Une « zone grise », a été identifiée, correspondant aux naissances à 24 et 25 semaines d’aménorrhée, et les attitudes adoptées en cas de naissance en deçà et au-delà de cette zone ont été décrites. Dans la zone grise, les décisions sont prises au nom du meilleur intérêt de l’enfant. Elles sont élaborées en partenariat avec les futurs parents, loyalement et clairement informés, en s’efforçant de respecter les procédures prévues par la loi du 22 avril 2005 pour encadrer les décisions d’abstention de réanimation/soins intensifs. Ces dernières ne correspondent jamais à une abstention de soins. L’alternative à l’option réanimation/soins intensifs, en effet, est celle du recours immédiat à des soins de confort, ayant pour but d’éviter la souffrance pendant la période précédant le décès, conséquence de l’extrême prématurité. Les schémas de prise en charge individualisés proposés aux futurs parents en prénatal s’appuient sur l’âge gestationnel et les autres facteurs pronostiques. À 25 semaines, l’association d’éléments cliniques de mauvais pronostic (restriction de croissance…), et/ou le mauvais état de l’enfant à la naissance, peuvent faire renoncer à l’option réanimation/soins intensifs. À 24 semaines, l’absence d’éléments cliniques aggravant le pronostic, et une demande de réanimation de la part des parents, jouent un rôle majeur dans le choix entre réanimation/soins intensifs et soins de confort (ou palliatifs).

المؤلفون: Field, D.¹ david.field@uhl-tr.nhs.uk, Bajuk, B.², Manktelow, B. N.¹, Vincent, T.², Dorling, J.¹, Tarnow-Mordi, W.³, Draper, E. S.¹, Henderson Smart, D.²

المصدر: Archives of Disease in Childhood -- Fetal & Neonatal Edition. May2008, Vol. 93 Issue 3, pF212-F216. 5p. 3 Charts.

مصطلحات موضوعية: *PREMATURE labor, *PREMATURE infants, *CHILDBIRTH, *NEONATAL intensive care

مصطلحات جغرافية: AUSTRALIA, UNITED Kingdom

مستخلص: Background: Comparisons of national perinatal and neonatal mortality often neglect the underlying causes. Objective: To assess effects of very-preterm births in the UK and Australia. Setting: Two geographically defined populations: the former Trent Health Region of the UK and New South Wales (NSW)/the Australian Capital Territory (ACT), Australia. Method: All births 22+0 to 31+6 weeks in 2000, 2001 and 2002 were identified by established surveys of perinatal care. Rates of birth and death were compared. Results: The population of NSW/ACT was 35% higher and there were 66% more births than in Trent (273 495 vs 164 824). The proportion of liveborn infants between 22 and 31 weeks gestation was about 25% higher in Trent (NSW/ACT 2945, rate per 1000 live births 10.82 (95% Cl 10.43 to 11.22); Trent 2208, rate per 1000 live births 13.47 (95% Cl 12.92 to 14.05)). The proportion of these infants admitted to a neonatal unit was also higher in Trent (91.2% vs 94.4%; OR 1.63(95% Cl 1.30 to 2.05)). Unadjusted mortality in infants admitted to a neonatal unit was similar: NSW/ACT 332/2686 (12.4%); Trent 284/ 2085 113.6%); unadjusted OR 1.12 (95% Cl 0.94 to 1.33; p=0.21). Conclusions: The higher rates of very premature birth and more ready admission to neonatal intensive care for infants in the UK may help to explain why perinatal and neonatal mortality are higher there than in Australia. Efforts to understand why the rate of premature birth in the UK is so high should be a national priority. [ABSTRACT FROM AUTHOR]

المؤلفون: Zeballos-Sarrato, Susana, Villar-Castro, Sonia, Zeballos-Sarrato, Gonzalo, Ramos-Navarro, Cristina, González-Pacheco, Noelia, Sánchez Luna, Manuel

المصدر: Journal of Maternal-Fetal & Neonatal Medicine; Nov2016, Vol. 29 Issue 22, p3660-3664, 5p

مصطلحات موضوعية: SURVIVAL analysis (Biometry), PREMATURE infant death, PERINATAL death, PREMATURE labor, CHILDBIRTH, GESTATIONAL age, PREMATURE infants, INFANT mortality, MORTALITY, NEONATAL intensive care, SURVIVAL, NEONATAL intensive care units

مصطلحات جغرافية: SPAIN

مستخلص: Objective: The purpose of this study was to assess the variability in neonatal survival to discharge from the neonatal unit by using different inclusion criteria.Methods: An observational and descriptive study was performed between January 2008 and December 2013 which included infants born between 22 weeks and 31 weeks and 6 d of gestation. The rate of survival was calculated using three different inclusion criteria: the total number of preterm births, the number of all preterm live births, and the number of preterm newborns admitted to the neonatal unit.Results: A total of 783 patients met the inclusion criteria. The survival rate for births between 22 and 31 weeks and 6 d of gestation was 72.8% of total births, 82.3% of live births, and 84.0% of all admissions to the neonatal unit. Therefore, we found a significant difference in survival rates according to whether or not foetal mortality (11.6%) and mortality in the delivery room (2.0%) were included. This variation increased with decreasing gestational age: 17,2%, 25%, and 38,4% at 23 weeks gestation.Conclusions: Late foetal mortality and the mortality in the delivery room affect the survival rates of preterm infants significantly, especially the most immature newborns. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Maternal-Fetal & Neonatal Medicine is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

العنوان البديل: Estimation of the utility of administration of antenatal corticosteroids in pregnant women with risk of birth in the late preterm period.

المؤلفون: Olaru, Octavian Gabriel¹ dr.olaruog@yahoo.ro, Pleş, Liana¹

المصدر: Ginecologia.ro. 2019 Supplement S2, p77-77. 1p.

مصطلحات موضوعية: *PREMATURE labor, *NEONATAL intensive care, *CHILDBIRTH, *PREGNANT women, *VITAL records (Births, deaths, etc.)

الملخص (بالإنجليزية): Introduction. More and more specialists argue that preventive use of antenatal corticosteroids should be included among the measures adopted to improve prognosis for the newborns in late preterm period (34-36 weeks of gestation). Objective. The purpose of this study was to determine whether there is benefit from antenatal corticosteroids administration in neonates born in the late premature period. Materials and method. We conducted a retrospective study in our clinic analyzing the data recorded over the past two years. Two batches were formed depending on whether or not corticosteroids were given antenatally. Morbidity and mortality rates for each group were analyzed and compared. Results. During the study period, 3,357 live births were registered, of which 402 were premature (12%). The confirmation of prematurity was made by corroborating obstetrical data with Ballard Score. Of the 257 newborns considered as being born in the late preterm period, in 49 cases, representing 19%, antenatal corticosteroids were administered, especially when there were doubts about the actual gestational age. The incidence of admission in the neonatal intensive care department, as well as the morbidity due to different causes were significantly higher (p<0.05) in the preterm group who did not receive antenatal corticosteroids. Conclusions. Our findings suggest that administering antenatal corticosteroids to pregnant women at birth at 34-36 weeks is beneficial and could significantly reduce morbidity associated with late preterm birth. [ABSTRACT FROM AUTHOR]

Abstract (Romanian): Introducere. Din ce în ce mai multe voci susţin că între măsurile adoptate pentru a îmbunătăţi prognosticul în cazul nou-născuţilor din perioada prematură târzie (34-36 de săptămâni de gestaţie) trebuie inclusă şi administrarea preventivă a corticosteroizilor antenatal. Obiectiv. Scopul acestui studiu a fost de a determina dacă există un beneficiu prin administrarea de corticosteroizi antenatal în cazul nou-născuţilor din perioada prematură târzie. Materiale şi metodă. Am realizat un studiu retrospectiv în clinica noastră, analizând datele înregistrate în ultimii doi ani. Au fost formate două loturi, în funcţie de faptul dacă au primit sau nu corticosteroizi antenatal. Ratele de morbiditate şi mortalitate pentru fiecare grup au fost analizate şi comparate. Rezultate. În timpul perioadei studiate, au fost înregistraţi 3.357 de nou-născuţi vii, dintre care 402 au fost prematuri (12%). Confirmarea prematurităţii a fost făcută prin coroborarea datelor obstetricale cu Scorul Ballard. Din 257 de nou-născuţi încadraţi ca fiind născuţi în perioada de prematuritate târzie, în 49 de cazuri, reprezentând 19%, s-au administrat corticosteroizi antenatal, în special atunci când au existat îndoieli privind vârsta reală de gestaţie. Incidenţa admiterii în compartimentul de terapie intensivă neonatală, precum şi morbiditatea prin diferite cauze au fost semnificativ mai mari (p<0,05) în grupul de prematuri care nu au primit corticosteroizi antenatal. Concluzii. Constatările noastre sugerează că administrarea corticosteroizilor antenatal la gravidele cu risc de naştere la 34-36 de săptămâni este benefică şi ar putea reduce în mod semnificativ morbiditatea asociată cu naşterea în perioada prematură târzie. [ABSTRACT FROM AUTHOR]

المؤلفون: Yasamin H. Sharif Al-Shibany, Saba M. Swadi Al-Thuwainy

المصدر: Al-Qadisiah Medical Journal; 2015, Vol. 11 Issue 20, p176-183, 8p

مصطلحات موضوعية: TREATMENT effectiveness, OXYTOCIN, PREMATURE labor, CHILDBIRTH, NEONATAL intensive care

الملخص (بالإنجليزية): Background and Objectives: preterm labor complicates 5-10% of pregnancies and is a leading cause of neonatal morbidity and mortality worldwide and 70-80% of perinatal deaths occur in preterm infants. The aim of this study is to compare the effectiveness, safety and adverse effects of the oxytocin antagonist medication(atosiban) with those of beta-adrenergic agonist (salbutamol) in the treatment of patients with preterm labor. Patients and Methods: one hundred pregnant women with preterm labor were enrolled in this study from the period of( January 2014 – January 2015) at Al- Diwaniya Maternity and Pediatrics Teaching Hospital-Iraq with a gestational age of 24-34 weeks, they were randomly assigned to receive tocolytics either salbutamol (n=50) or atosiban (n=50).Salbutamol was given by(intravenous infusion 10-50 microgram)for up to 48 hour. Atosiban was given by (intravenous bolus dose of 6.75 mg then 300microgram/minute for 3 hour and 100microgram/minute for up to 48hour). Retreatment with the study drugs or alternative tocolytic agents was allowed. Main outcome measures included were tocolytic effectiveness, which was assessed in terms of number of women undelivered after 48hour and 7 days. Tocolytic safety was assessed in terms of maternal and fetal side effects and neonatal morbidity. Results: there were no significant differences between the salbutamol and the atosiban group in prolongation of pregnancy for 48 hour (44% versus 46%;p=0841)and 7 days(20% versus 32%;p=0.171) ,respectively. Maternal adverse events, including tachycardia occurred more frequently in the salbutamol group(22% versus 8%;p=0.050).Neonatal outcomes and complications were comparable between the two study groups(42% versus 32%;p=0.30). Conclusions: the oxytocin antagonist (atosiban) was as effective as betaagonist( salbutamol) in delaying threatened preterm birth, and found to be better tolerated by both the mother and fetus than salbutamol, with a comparable neonatal safety profil.This study supports the clinical use of atosiban as a first line tocolytic in the treatment of preterm labor. [ABSTRACT FROM AUTHOR]

الملخص (بالعربية): التأثيرات و الاعراض الجانبية لاستخدام عقار الاتوسيبان و هو عامل مضاد للاوكسيتوسين البشري عند مستقبلات الخلية بالمقارنة مع عقار السالبيوتامول وهو عامل محفز لمستقبلات البيتا في الخلية البشرية العلاج حالات الولادة المبكرة. الطريقة: أجريت الدراسة في مستشفى الولادة و الأطفال التعليمي في الديوانية العراق ، للفترة من ( شهر كانون الثاني/2014 و لغاية شهر كانون الثاني/2015 ) على 100 امرأة حامل بعمر (18-35 سنة) و ادخلن الى قسم الطواري مع اعراض للولادة المبكرة و كانت فترة الحمل من ( 24-34 أسبوع) مع وجود انقباضات للرحم تستغرق 30 ثانية بمعدل > أربعة انقباضات خلال 60 دقيقة و كان اتساع عنق الرحم من 1 الى 3 سم) و (الى 3 سم) للسيدات عديمة الولادة وسرعة نبض الجنين طبيعية، تم تقسيم المريضات الى مجموعتين: المجموعة الأولى و عددها 50 مريضة عولجت بعقار السالبيوتامول عن طريق محلول الحقن الوريدي و المجموعة الثانية 50 مريضة عولجت بعقار الأتوسيبان الوريدي مع مراقبة شدة الانقباضات و الأعراض الجانبية لكل عقار على الأم و الجنين لغرض تأخير الولادة المبكرة و تقليل المضاعفات السريرية و الوفيات لدى المواليد الخدج حديثي الولادة. النتائج: لم يكن هناك اختلاف في تأخير حالات الولادة المبكرة لمدة 48 ساعة (44% مقابل 46%) و 7 أيام (20% مقابل 32%) بين المجموعة الأولى و الثانية على التوالي و لكن الأعراض الجانبية مثل تسارع نبضات قلب الأم كانت اكثر عند المجموعة الأولى التي عولجت بعقار السالبيوتامول (22% مقابل 8%). لم تكن هناك اختلافات في النتائج الإحصائية للمضاعفات السريرية لدى المواليد الخدج حديثي الولادة بين المجموعتين. الاستنتاج: استخدام عقار الأتوسيبان له نتائج مقاربة لاستخدام عقار السالبيوتامول في تأخير حدوث الولادة المبكرة و لكن له أهمية سريرية افضل من السالبيوتامول بسب قلة الأعراض الجانبية لدى الأم و الجنين و ننصح باستخدامه كأول خط علاجي لحالات الولادة المبكرة لتقليل المضاعفات و نسب الوفيات لدى الخدج حدیثی الولادة. [ABSTRACT FROM AUTHOR]

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