[ABSTRAK
Latar belakang: Persalinan prematur sekarang ini menjadi tantangan dibidangobstetri. Ini terlihat dari tingginya angka prematur di dunia. Dua hal yang harusdiperhatikan dalam kehamilan prematur yaitu kontraksi dan pemberian kortikosteroiduntuk pematangan paru, maka dibutuhkan suatu penanganan dengan menggunakanobat tokolitik. Saat ini telah banyak digunakan terbutalin sulfat yang merupakangolongan agonis beta dan juga nifedipine yang merupakan golongan penyekat kanalkalsium. Namun penggunaan agonis beta menyebabkan efek yang kurang baik padaibu seperti takikardi, dispnoe dan ansietas sehingga penggunaannya sekarang mulaiterbatas. Tujuan: Tesis ini bertujuan mengetahui perbandingan efektifitas nifedipineoral dibandingkan dengan terbutalin sulfat sebagai tokolitik dalam kehamilanprematur. Metode: Penelitian ini merupakan uji klinis randomisasi tanpa penyamaranpada ibu hamil prematur di kurang dari 34 minggu di RSUPN Cipto mangunkusumo.Hasil: dari 60 subyek yang diikutsertakan dengan consecutive sampling, didapatkan56 subyek (93,3%) hilang kontraksi dengan rincian 27 subyek (90,0%) padakelompok nifedipin dan 29 subyek (96,7%) pada kelompok terbutalin (p=0,61).Kelompok yang diberikan nifedipin hilang kontraksi dengan median waktu 1,25(0,67-2,00) jam sementara kelompok yang diberikan terbutalin hilang kontraksi lebihcepat dengan median waktu 0,50 (0,50-1,50) jam (p<0,001). Tidak ada perbedaan efek samping yang ditemukan pada kedua kelompok. Simpulan: Nifedipin dan terbutalin memiliki efektifitas yang sama pada kehamilan prematur.
ABSTRACT
Background: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. ;Background: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. ;Background: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. , Background: Preterm labour is considered as one of problems frequentlyencountered in obstetric and ginecologic department. To date, the incidence ofprematurity is still high worldwide. Two things should be noted: uterine contractionand corticosteroid for lung maturity of the baby. Thus, a tocolytic agent may be usefulin these circumstances. To date, terbutaline sulfate is widely used as it is known asbeta agonist. Beside, nifedine, a calcium channel blocker, is also widely accepted. Theuse of beta agonist might contribute several adverse events related to the mother,including tachycardia, dispnea, and anxiety. Some physicians have begun to restrictits use. Objective: This study aimed to compare the efficacy of slow releasenifedipine and terbutaline sulfate injection as a tocolytic agent for preterm labour.Methods: This is a randomized clinical trial unblinding. Subjects were pregnantwomen with prematurity (below 34 weeks of gestational age) at CiptoMangunkusumo hospital. Results: From a total of 60 subjects, 56 subjects (93.3%)had no contraction after given tocolytic (27 subjects (90.0%) in nifedipine group and29 subjects (96.7%) in terbutaline sulfate group; (p= 0.61). Subjects in nifedipinegroup lost their contraction after the drug was given with median time of 1.25 (0.672.00)hours while subjects in terbutaline sulfate group lost their contraction withmedian time of 0.50 (0.50-1.50) hours (p<0.001). There was no significantly differentproportion of adverse event found in both groups. Conclusions: Nifedipine and terbutaline sulfate have relatively same efficacy to vanish uterine contraction for prematurity management. ] |
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