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논문KCI 등재

조기진통의 치료

Overview for the management of preterm labor

김암
대한산부인과학회 (Korean Soceity of Obstetrics and Gynecology)|2007.01|Obstetrics & Gynecology Science|제50권 제1호|pp. 5-15

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참고문헌

주제분류산부인과학

초록

=조산에 의해 출생한 조산아들은 영아사망의 절반을 차지할 뿐만 아니라 생존아 에서도 신경계 발달 장애, 호흡기계 이상 등의 이환율이 증가하는 것으로 알려져 있어 조산을 유발하는 원인과 치료에 대한 논란은 지속되어 왔다. 지난 40년 동안 여러 가지 치료에도 불구하고 조기진통이나 조산율, 신생아 사망률을 낮추지 못하였지만, 적극적인 치료를 통해 임신기간의 연장이나 신생아 이환율을 감소시키고 있다. 현재 국내에서 대표적으로 사용되고 있는 조기진통의 치료는 자궁수축억제제, 항생제, 스테로이드제로 요약될 수 있다. 아직까지 자궁수축억제제로 정립된 제제는 없지만, RCOG에서는 더 이상 1차 선택제로 베타 교감신경작용제를 추천하지 않고 비슷한 진통 억제 효과를 보이면서 부작용이 적은 아토시반이나 칼슘통로 차단제를 선호하고 있다. 이러한 자궁수축억제제, 항생제, 스테로이드제는 임신 24주에서 34주까지 투여하고, 34주 이상에서 분만이 임박한 상황이라면 약물요법보다는 분만을 고려하는 것이 원칙이다. 유지요법으로의 자궁수축억제제의 사용은 권고되지 않는다. 현재까지 조기진통의 치료효과에 대해 많은 논란이 있지만, 각각의 산모가 처한 상황과, 임신주수, 산모와 태아에게 미치는 영향 등을 고려하여 개별적 치료가 이루어지게 하는 것이 바람직하다.

참고문헌 (73)

  1. "Management of preterm labor. Number 43, May 2003", 82, pp.127~135 (2003)
  2. "Epidemiology of preterm delivery", 23, pp.17~31 (1980)
  3. "Factors associated with spontaneous pre-term birth", 83, pp.342~50 (1976)
  4. "Issues in the management of preterm labor", 31, pp.354~358 (2005)
  5. "Preterm delivery", 360, pp.1489~1497 (2002)
  6. "조기진통 처치의 최신지견", 49, pp.1403~1411 (2006)
  7. "Do tocolytic agents stop preterm labor? A critical and comprehensive review of efficacy and safety", 168, pp.1247~1256 (1993)
  8. "조기진통의 약물요법", 36, pp.441~51 (1993)
  9. "The prevalence of thromboembolic events among women with extended bed rest prescribed as part of the treatment for premature labor or preterm premature rupture of membranes", 182, pp.1089~1092 (2000)
  10. "Calcium homeostasis in pregnancy and lactation", 72, pp.509~13 (1993)
  11. "Prevention of preterm birth in patients with symptoms of preterm labor-the benefits of psychologic support", 177, pp.947~952 (1997)
  12. "Preterm delivery:an overview", 82, pp.687~704 (2003)
  13. "Guidelines for the management of spontaneous preterm labor", 34, pp.359~366 (2006)
  14. "An update on the controversies of tocolytic therapy for the prevention of preterm birth", 82, pp.1~9 (2003)
  15. "Beta-mimetics in preterm labour:an overview of the randomized controlled trials", 95, pp.211~22 (1988)
  16. "The Canadian Preterm Labor Investigators Group", 327, pp.308~12 (1992)
  17. "Tocolytic treatment for the management of preterm labor: a review of the evidence", 188, pp.1648~1659 (2003)
  18. "Cardiac isoenzymes and electrocardiographic changes during ritodrine tocolysis", 161, pp.318~21 (1989)
  19. "The pathophysiology of pulmonary oedema with the use of beta-agonists", 107, pp.439~444 (2000)
  20. "Is there a need to treat hypokalaemia associated with intravenous salbutamol infusion?", 23, pp.381~387 (1997)
  21. "Tocolytics drugs for women in preterm labour" (2002), RCOG Press
  22. "Therapeutic agents in preterm labor:tocolytic agents", 43, pp.787~801 (2000)
  23. "Calcium channel blockers for inhibiting preterm labour; a systematic review of the evidence and a protocol for administration of nifedipine", 43, pp.192~198 (2003)
  24. "Cardiovascular and metabolic effects associated with nifedipine and ritodrine tocolysis", pp.788~95
  25. "Evidence-based labour ward guidelines for the diagnosis, management and treatment of spontaneous preterm labour", 23, pp.469~478 (2003)
  26. "Tocolysis with nifedipine or beta-adrenergic agonists:a meta-analysis", 97, pp.840~847 (2001)
  27. "Calcium channel blockers for inhibiting preterm labour" (2003)
  28. "Atosiban and nifedipine in acute tocolysis:a comparative study", 128, pp.129~134 (2006)
  29. "Atosiban and nifedipin for the treatment of preterm labor", 91, pp.10~14 (2005)
  30. "Effectiveness of nifedipine versus atosiban for tocolysis in preterm labour:a meta-analysis with an indirect comparison of randomized trials", 110, pp.1045~1049 (2003)
  31. "Effect of nifedipine on fetal and maternal hemodynamics and blood gases in the pregnant ewe", 176, pp.922~930 (1997)
  32. "Nifedipine. Dose-related increase in mortality in patients with coronary heart disease", 92, pp.1326~1331 (1995)
  33. "Calcium channel blockers for tocolysis:a review of their role and safety following reports of serious adverse events", 126, pp.137~145 (2006)
  34. "Risk of gastrointestinal haemorrhage with calcium antagonists in hypertensive persons over 67 years old", 347, pp.1061~1065 (1996)
  35. "Long-term follow up of children exposed in utero to nifedipine or ritodrine for the management of preterm labour", 113, pp.324~331 (2006)
  36. "Acute tocolysis", 17, pp.151~156 (2005)
  37. "Dose ranging study of the oxytocin antagonist atosiban in the treatment of preterm labor. Atosiban Study Group", 88, pp.331~336 (1996)
  38. "The Worldwide Atosiban versus Beta-agonists Study Group", 108, pp.133~142 (2001)
  39. "An oxytocin receptor antagonist (atosiban) in the treatment of preterm labor: a randomized, double-blind, placebo- controlled trial with tocolytic rescue", 182, pp.1173~1183 (2000)
  40. "Multicentre, parallel group, randomised, single-blind study of the safety and efficacy of atosiban versus ritodrine in the treatment of acute preterm labour in Korean women", 113, pp.1228~1234 (2006)
  41. "Further study of the inhibition of premature labor by indomethacin"
  42. "Neonatal complications after the administration of indomethacin for preterm labor", 329, pp.1602~7 (1993)
  43. "A double-blind randomized study of fetal side effects during and after the short-term maternal administration of indomethacin and nimesulide for the treatment of preterm labor", 188, pp.1046~1051 (2003)
  44. "조산억제를 위한 magnesium sulfate의 효과", 23, pp.487~492 (1980)
  45. "Magnesium sulfate for tocolysis and risk of spastic cerebral palsy in premature children born to women without preeclampsia", 183, pp.717~725 (2000)
  46. "Endocrine and paracrine regulation of birth at term and preterm", 21, pp.514~550 (2000)
  47. "Efficacy of 17alpha-hydroxyprogesterone caproate in the prevention of premature labor", 293, pp.675~80 (1975)
  48. "Prophylactic administration of progesterone by vaginal suppository to reduce the incidence of spontaneous preterm birth in women at increased risk:a randomized placebo-controlled double-blind study", 188, pp.419~424 (2003)
  49. "Prevention of recurrent preterm delivery by 17 alpha-hydroxyprogesterone caproate", 348, pp.2379~2385 (2003)
  50. "A meta-analysis of randomized control trials of progestational agents in pregnancy", 96, pp.265~74 (1989)
  51. "Progesterone for the prevention of preterm birth among women at increased risk:a systematic review and meta-analysis of randomized controlled trials", 194, pp.1234~1242 (2006)
  52. "Use of antibiotics to prevent preterm birth", 177, pp.375~380 (1997)
  53. "Broad-spectrum antibiotics for spontaneous preterm labour: the ORACLE II randomised trial. ORACLE Collaborative Group", 357, pp.989~994 (2001)
  54. "Gestational bleeding, bacterial vaginosis, and common reproductive tract infections: risk for preterm birth and benefit of treatment", 93, pp.715~724 (1999)
  55. "Nutritional and antimicrobial interventions to prevent preterm birth:an overview of randomized controlled trials", 53, pp.575~585 (1998)
  56. "Utility of antibiotic therapy in preterm premature rupture of membranes:a meta-analysis", 51, pp.324~328 (1996)
  57. "Intrauterine infection and prematurity", 8, pp.3~13 (2002)
  58. "The role of prophylactic antibiotic therapy for preterm labour and preterm prelabour rupture of the membranes", 94, pp.196~197 (2001)
  59. "Premature rupture of the membranes:an evidence-based approach to clinical care", 18, pp.397~413 (2001)
  60. "Infection, antibiotics, and preterm delivery", 25, pp.295~309 (2001)
  61. "Preterm labour", 14, pp.105~113 (2002)
  62. "Antenatal corticosteroid therapy: a meta-analysis of the randomized trials, 1972 to 1994", 173, pp.322~335 (1995)
  63. "The incidence of respiratory distress syndrome does not increase when preterm delivery occurs greater than 7 days after steroid administration", 38, pp.8~10 (1998)
  64. "Single versus repeated-course antenatal corticosteroids:outcomes in singleton and multiple-gestation pregnancies", 18, pp.267~267 (2001)
  65. "Benefits of maternal corticosteroid therapy in infants weighing <", =1000 grams at birth after preterm rupture of the amnion, 1999, pp.180, 677~682
  66. "Antenatal corticosteroids-too much of a good thing?", 286, pp.1628~1630 (2001)
  67. "The effect of steroids on the biophysical profile and Doppler indices of umbilical and middle cerebral arteries in healthy preterm fetuses", 99, pp.72~76 (2001)
  68. "Double-blind, randomized, controlled trial of atosiban and ritodrine in the treatment of preterm labor: a multicenter effectiveness and safety study", 182, pp.1191~1199 (2000)
  69. "Efficacy of oral beta-agonist maintenance therapy in preterm labor:a meta-analysis", 85, pp.313~317 (1995)
  70. "Oral ritodrine maintenance in the treatment of preterm labor", pp.212~9
  71. "Terbutaline pump maintenance therapy for prevention of preterm delivery:a double-blind trial", 179, pp.874~878 (1998)
  72. "Oral nifedipine maintenance therapy after acute intravenous tocolysis in preterm labor", 32, pp.220~224 (2004)
  73. "Maintenance therapy with calcium channel blockers for preventing preterm birth after threatened preterm"

관련 논문AI추천

조기 진통의 처치박윤기영남대학교 의과대학 · Journal of Yeungnam Medical Science1999 · 제16권 제2호Practice patterns in the management of threatened preterm labor in Korea: A multicenter retrospective study조윤*, 강윤단, 곽동욱, 길기철, 김영주, 김영한, 김종운, 나성훈, 박교훈, 신재은, 심재윤, 오관영, 이경아, 이순애, 이승미, 이준호, 임지영, 조금준, 진찬희, 최규연, 최석주, 최세경, 허성은, 황한성대한산부인과학회 · Obstetrics & Gynecology Science2015 · 제58권 제3호조기진통 처치의 최신지견신종철대한산부인과학회 · Obstetrics & Gynecology Science2006 · 제49권 제7호조기분만진통 환자에서 경구 니칼디핀과 정맥내 리토드린의 치료효과최진, 강명선, 강우대, 김윤하, 송태복, 오윤상, 조문경대한산부인과학회 · Obstetrics & Gynecology Science2002 · 제45권 제12호산전 부신피질 호르몬 요법이 태아 성장에 미치는 영향김종화, 노정래, 양순하, 오수영, 최석주대한산부인과학회 · Obstetrics & Gynecology Science2006 · 제49권 제1호산전 부신피질 호르몬 다회 요법이 주산기 예후에 미치는 영향김종화, 노정래, 서은성, 송승은, 오수영, 정경란, 조현지, 최석주대한산부인과학회 · Obstetrics & Gynecology Science2007 · 제50권 제5호

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