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OBJECTIVE To establish evaluation criteria for rational drug use of atosiban in clinic， and to provide reference for rational drug use of atosiban in clinic. METHODS Based on the drug instructions of atosiban acetate injection and related guidelines， the experts of the Evaluation Group of Rational Drug Use formulated the evaluation criteria of rational drug use， including 5 primary indexes and 8 secondary indexes. The weight coefficients of secondary indexes were calculated by analytic hierarchy process （AHP）， and the use of atosiban acetate injection in 190 pregnant women from the Third Affiliated Hospital of Guangzhou Medical University （referred to as “our hospital”） was evaluated retrospectively by technique for order preference by similarity to an ideal solution （TOPSIS）. The evaluation results were divided into three levels including reasonable， basic reasonable and unreasonable application based on the relative approach degree. RESULTS Among 190 pregnant women， 49 （25.8%） were treated with atosiban reasonably， 39 （20.5%） were treated with atosiban basic reasonably， and 102 （53.7%） were treated with atosiban unreasonably. The evaluation results obtained by AHP-TOPSIS method were consistent with the actual situation in clinic. The main problems of the unreasonably use were super indications， unreasonable usage and dosage， over the course of treatment and the lack of proper economic consideration. CONCLUSIONS The rationality evaluation criteria of atosiban’s clinical application are established by AHP-TOPSIS method； the evaluation results obtained by this method are quantifiable， scientific and reliable. The unreasonable use of atosiban is common in our hospital， and the management should be strengthened in clinical application.
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【Objective】 To investigate the effects of atosiban combined with ritodrine hydrochloride on clinical efficacy， serological indicators and maternal and infant outcomes of patients with threatened premature delivery. 【Methods】 A total of 138 patients with threatened preterm delivery in the Department of Obstetrics and Gynecology of The First Affiliated Hospital of Air Force Military Medical University from June 2018 to June 2020 were collected and divided into two groups according to random number table method， with 69 patients in the control group treated with ritodrine hydrochloride and 69 patients in the study group treated with atosiban on the basis of the control group. Clinical efficacy， changes in serological indicators， maternal and child outcomes， and drug safety were compared between the two groups. 【Results】 There were 65 effective cases in the study group （94.20%） and 56 effective cases in the control group （81.16%）. There were statistically significant differences between the two groups （P0.05）. After treatment， timp-1， il-8， il-6， NO and PGE2 levels in the study group were significantly lower than those in the control group （P<0.05）. The success rate of fetal preservation， gestational age， neonatal weight and Apgar score were significantly higher in the study group than in the control group， while the rate of premature delivery was significantly lower than that in the control group （P<0.05）. The incidence of drug-induced adverse reactions （5.80%） was significantly lower in the study group than in the control group （26.09%） （P<0.05）. 【Conclusion】 Atosiban combined with ritodrine hydrochloride can effectively prolong pregnancy， reduce the level of serological indicators， improve maternal and infant outcomes， with fast effect， safe and significant efficacy. Therefore， it is worthy of application and promotion in the treatment of patients with threatened premature delivery.
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Este trabajo trata de la actualización del uso de ATOSIBAN para el tratamiento de la amenaza de parto prematuro, utilizando para su aplicación el protocolo de administración de Tractocile en el servicio de partes vs internado general, a los efectos de sistematizar los cuidados de enfermería en la utilización de este medicamento.
Subject(s)
Humans , Female , Pregnancy , Obstetric Labor, Premature , Tocolysis , Tocolytic Agents/administration & dosageABSTRACT
Objective To investigate the influence of atosiban on the pregnancy outcome in patients with repeated implantation failure(RIF)in blastcyst thawed embryo transfer(bTET) Methods From January 2014 to December 2015,a total of 262 RIF patients undergoing bTET were retrospectively studied. They were divided into study group with a single bolus dose (6.75 mg/0.9 mL,iv) of atosiban before bTET (n = 94),and control groupwithout atosiban(n = 168). Results The clinical pregnancy rate(57.41%),implantation rate(38.41%) and living-birth rate(46.81%) of study group were significantly higher than those of control group (41.12%, 28.32% and 33.93% respectively;P 0.05). Conclusion Atosiban treatment before embryo transfer may improve pregnancy outcomes of RIF patients in bTET.
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OBJECTIVE: Uterine contraction induced by the embryo transfer (ET) process has an adverse effect on embryo implantation. The aim of this study was to determine the effect of oxytocin antagonist supplementation on the day of ET on in vitro fertilization outcomes via a meta-analysis. METHODS: We performed a meta-analysis of randomized controlled trials (RCTs). Four online databases (Embase, Medline, PubMed, and Cochrane Library) were searched through May 2015 for RCTs that investigated oxytocin antagonist supplementation on the day of ET. Studies were selected according to predefined inclusion criteria and meta-analyzed using RevMan 5.3. Only RCTs were included in this study. The main outcome measures were the clinical pregnancy rate, the implantation rate, and the miscarriage rate. RESULTS: A total of 123 studies were reviewed and assessed for eligibility. Three RCTs, which included 1,020 patients, met the selection criteria. The implantation rate was significantly better in patients who underwent oxytocin antagonist infusion (19.8%) than in the control group (11.3%) (n=681; odds ratio [OR], 1.92; 95% confidence interval [CI], 1.25–2.96). No significant difference was found between the two groups in the clinical pregnancy rate (n=1,020; OR, 1.57; 95% CI, 0.92–2.67) or the miscarriage rate (n=456; OR, 0.76; 95% CI, 0.44–1.33). CONCLUSION: The results of this meta-analysis of the currently available literature suggest that the administration of an oxytocin antagonist on the day of ET improves the implantation rate but not the clinical pregnancy rate or miscarriage rate. Additional, large-scale, prospective, randomized studies are necessary to confirm these findings.
Subject(s)
Female , Humans , Pregnancy , Abortion, Spontaneous , Embryo Implantation , Embryo Transfer , Embryonic Structures , Fertilization in Vitro , In Vitro Techniques , Odds Ratio , Outcome Assessment, Health Care , Oxytocin , Patient Selection , Pregnancy Rate , Prospective Studies , Uterine ContractionABSTRACT
Aims: To evaluate the efficacy, safety and tolerability of atosiban in delaying preterm labour. Study Design: A prospective, open label, non comparative study. Place of Study: Lokmanya Tilak Municipal Medical College Mumbai, India. Methodology: Pregnant women (N=110) between the gestational age of 24 to 34 weeks, presenting with signs of preterm labour were enrolled in the study. Efficacy, safety and tolerability of Atosiban were assessed for a period of 72 hrs. Results: Ninety Eight patients (89.09%) remained undelivered up to 72 hrs after completion of treatment phase and ninety seven patients (88.18%) till the end of their hospital stay (upto 7 days). There were six patients with twin and one with quadruplet pregnancy; atosiban therapy was successful in delaying labour upto discharge from hospital in all the seven patients. The study medication was well tolerated as no adverse events were observed throughout the study duration. Conclusion: Atosiban, an oxytocin receptor antagonist, has proven to be an effective and well tolerated tocolytic drug and because of its favourable safety profile, it may be the best choice as a tocolytic therapy to delay the preterm labour.
ABSTRACT
Atosiban is a representative drug of oxytocin receptor antagonists and has a good effect on preterm's treatment. It inhibits oxytocin's effect competitively by binding to oxytocin receptor on myometrial and decidual. It also prevents the second messager formation and calcium mobilization. The studies up to date have shown that Atosiban effectively inhibits uterine contractions with little side effects. The article briefly summarizes the current understanding of Atosiban.