V.F.Snegirev Archives of Obstetrics and GynecologyV.F.Snegirev Archives of Obstetrics and GynecologyАрхив акушерства и гинекологии им. В.Ф. Снегирева2313-87262687-1386Eco-Vector62652910.17816/aog626529ReviewsНаучные обзорыReview ArticleCurrent possibilities and prospects of tocolytic therapyТоколиз в современном акушерстве: возможные перспективы现代产科中的分娩镇痛：可能的前景https://orcid.org/0009-0001-5459-30542275-4803KiryanovaAnastasia O.КирьяноваАнастасия ОлеговнаKiryanovaAnastasia O.
Russian Federation

4th year student

студентка 4-го курса

4th year student

Anastasia.kiryanova2002@gmail.comhttps://orcid.org/0000-0003-0663-29092841-9638MurashkoAndrey V.МурашкоАндрей ВладимировичMurashkoAndrey V.
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

MD, Dr. Sci. (Medicine), Professor

murashko_a_v@staff.sechenov.ruI.M. Sechenov First Moscow State Medical UniversityПервый Московский государственный медицинский университетI.M. Sechenov First Moscow State Medical University09092024071020241132332440602202404062024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-ВекторCopyright ©; 2024,2024Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0/https://archivog.com/2313-8726/article/view/626529

The urgency of the problem of preterm birth (PB) is because of its high prevalence and neonatal mortality. The effects of PB on the fetus are often fatal, and PB accounts for 70% of neonatal mortality and 36% of infant mortality. Severe neurological deficits (e.g., cerebral palsy, epilepsy, intraventricular hemorrhages, retinopathy, blindness, hearing loss, delayed neuropsychiatric and motor development) occur in 68% of surviving premature infants. Additionally, children born prematurely have a high risk for purulent septic diseases. The metabolic consequences of prematurity cause diseases such as metabolic syndrome and hypertension. Thus, tocolytic therapy is a crucial therapeutic measure in obstetrics. However, most known and actively used tocolytic drugs induce insufficient effect for long-term prolongation of pregnancy or have serious side effects. Currently, there is a search for new tocolytics to obtain safe, adequate, and long-term effects. This review examines promising and relevant drugs that may be used in routine obstetric practice. Scientific articles, meta-analyses, and systematic reviews from the databases PubMed, Embase, Web of Science, and Google Scholar, and RSCI were analyzed. For the analysis, publications in English and posted no more than 5 years before the study was conducted were selected, except for fundamental works with a longer publication period.

Актуальность проблемы преждевременных родов (ПР) обусловлена высокой распространённостью и неонатальной смертностью. Последствия ПР для плода часто бывают фатальными: на их долю приходится 70% неонатальной смертности и 36% — младенческой. Тяжёлый неврологический дефицит (детский церебральный паралич, эпилепсия, внутрижелудочковые кровоизлияния, ретинопатия, слепота, потеря слуха, задержка нервно-психического и моторного развития) присутствует у 68% выживших недоношенных детей. Кроме того, дети, преждевременно рождённые, имеют высокий риск гнойно-септических заболеваний. Метаболические последствия недоношенности формируют предпосылки для развития таких заболеваний, как метаболический синдром и артериальная гипертензия. В этой связи весьма важным и актуальным лечебным мероприятием в акушерстве является токолитическая терапия. Однако большинство известных и активно применяющихся токолитических препаратов обладают недостаточным для длительного пролонгирования беременности результатом или ассоциированы с серьёзными побочными эффектами. В настоящее время идёт активный поиск новых токолитиков с целью получения наиболее безопасного, мощного и долгосрочного эффекта. В данной обзорной статье рассмотрены наиболее перспективные и актуальные препараты, которые имеют хорошие шансы войти в рутинную акушерскую практику. Для этого проанализированы научные работы, метаанализы, систематические обзоры, находящиеся в открытом доступе в базах данных PubMed, Embase, Web of Science, Google Scholar и РИНЦ. Для анализа преимущественно отбирали публикации, вышедшие на английском языке и размещённые в базах данных не более пяти лет назад, за исключением фундаментальных работ с более давним сроком публикации.

早产问题之所以紧迫，是因为其发病率和新生儿死亡率都很高。早产对胎儿的影响往往是致命的：占新生儿死亡率的70%，占婴儿死亡率的36%。68%的存活早产儿存在严重的神经系统缺陷（脑瘫、癫痫、脑室出血、视网膜病变、失明、听力损失、神经精神和运动发育迟缓）。此外，早产儿患化脓性败血症的风险也很高。早产的代谢影响是代谢综合征和高血压等疾病发展的先决条件。在这方面，溶血疗法是产科中非常重要和相关的治疗措施。然而，大多数已知和积极使用的促溶血药物在延长妊娠期方面效果不佳，或伴有严重的副作用。为了获得最安全、最有效和最持久的疗效，人们正在积极寻找新的促溶血药物。这篇综述文章探讨了最有希望进入常规产科实践的相关药物。为此，我们分析了开放数据库PubMed, Embase, Web of Science, Google Scholar和RSCI中的科学论文、荟萃分析和系统综述。为了进行分析，主要选择了不超过五年前在数据库中发布的英文出版物，但出版时间较长的基础著作除外。

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