НО-ШПА ПРИ БЕРЕМЕННОСТИ, УГРОЖАЮЩЕМ ВЫКИДЫШЕ И Т.П.

[Bez_pardon]

Уважаемые коллеги! В анотации к дротаверину (но-шпа) указана область применения:
Показания

– профилактика и лечение функциональных состояний и болевого синдрома, вызванных спазмом гладкой мускулатуры (в т.ч. спазмы ЖКТ, мочевыводящих путей, связанные с холелитиазом, холециститом, язвенной болезнью желудка, двенадцатиперстной кишки; спазм пилорического и кардиального отдела желудка; спастические запоры, спастический колит; проктит, тенезмы; послеоперационные колики вследствие задержки газов; в связи с нефролитиазом, пиелитом; вследствие инструментальных вмешательств);
– альгодисменорея;
– для снижения возбудимости матки при беременности; при спазме зева матки в родах, затяжном раскрытии зева, послеродовых схватках, угрожающем аборте; – спазмы периферических сосудов (в т.ч. при эндартериите);
– профилактика спазма гладкой мускулатуры при проведении инструментальных методов исследования.

В связи с возникшей в отделении дискуссии прошу вашей помощи в вопросе - обоснованности назначений при беременности (угрозах). Очень рад буду ссылкам! Заранее спасибо

[Dr.Vad]

Быть может, эти сведения помогут:

Recently, a controlled open, phase IV clinical trial has been performed demonstrating prominent effects for drotaverine on some parameters of human deliveries (Demeter, 1998). Drotaverine, given at a dose of 40 mg (i.m.) in the stage of cervical dilatation phase to parturients, significantly (P=0.005) shortened the time course of dilatation stage and highly significantly (P=0.001) lowered the incidence of cervical ruptures, which led to decreased obstetrical complications. No increase in the risk of atonia was observed. Although drotaverine caused some lowering in the blood pressure, this effect may be of beneficial influence on the stress accompanying labor (J. Demeter, G. Oszoli, Zs. Turi, A. Pal and Gy. Blaskó , Effect of intramuscularly administered NO-SPA injection on the dilatation stage of physiological deliveries. Magy. Noorv. Lapja 62 (1999), pp. 349–353.
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Int J Gynaecol Obstet. 2004 Jan;84(1):17-22.
Drotaverine hydrochloride for augmentation of labor.
Singh KC, Jain P, Goel N, Saxena A.
Department of Obstetrics & Gynecology and Anesthesiology, University College of Medical Sciences and GTB Hospital, Delhi, India.

OBJECTIVES: To study the use of drotaverine hydrochloride for acceleration of labor and relief of labor pains. METHODS: In this double-blind placebo-controlled randomized study, 100 primigravidas in uncomplicated spontaneous labor at term were given drotaverine hydrochloride or placebo (distilled water) intramuscularly. Labor events, including pain (assessed by a visual analog scale and a verbal rating scale), neonatal outcome, and side effects of the drug were recorded. Student's t-test was used for analysis. RESULTS: Forty-four patients in the drug group and 40 in the placebo group had complete data for analysis after decoding. In drotaverine group, there was a mean 15% reduction in the duration of the first stage of labor and a mean 19% reduction in the second stage. The maximum shortening of the first stage (28%) was observed when drotaverine was administered when cervical dilatation was 4 cm (P=0.044). There were no adverse fetal effects, but atonic postpartum hemorrhage was more common in the drotaverine group. There was no relief of pain with the drug except in the fourth stage of labor. CONCLUSIONS: Drotaverine hydrochloride is safe and effective in accelerating labor, but not effective in lessening labor pain.
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J Indian Med Assoc. 2007 Aug;105(8):450, 452.
Study of drotaverine on first stage of labour and pregnancy outcome.
Roy A, Patra KK, Mukhopadhyay S, Guha S.
Department of Obstetrics and Gynaecology, RG Kar Medical College and Hospital, Kolkata 700004.

A prospective randomised study of 200 women with spontaneous onset of labour was carried out in 100 women who were given 40mg of drotaverine hydrochloride intravenously at > or = 3cm dilatation of the cervix, the other 100 were taken as control. The effects of the drug on the progress and outcome of labour were noted. The mean durations of active phase of labour in primigravida and multigravida were 148.9 minutes and 99.5 minutes in drotaverine group whereas in control group were 331.6 minutes and 227.9 minutes respectively. It was concluded that drotaverine is highly effective in reducing the duration of active phase of labour by hastening cervical dilatation, more effective when given in more dilated cervix than with less dilatation and more effective in multigravida than in primigravida. There was no interference with uterine contractility and no increase in operative delivery. It reduces the incidence of traumatic postpartum haemorrhage by reducing the incidence of cervical tear. It is a safe drug for the mother as well as for the baby.

[Bez_pardon]

Спасибо за быстрый ответ, Вадим Валерьевич. Однако Ваши материалы связаны с родами. Меня больше интересует проблема угрожающих абортов в ранних сроках. И соответственно необходимость, обоснованность и безопасность применения дротаверина. Но все равно спасибо, прочитал, накрутил на мозх.