Efficacy of allylestrenol combined with ritodrine in treating preterm labour with preeclampsia and associated risk factors for pregnancy outcomes.

Abstract

Objectives: To evaluate the efficacy of diethylstilbestrol combined with ritodrine in treating preterm labor due to preeclampsia and to identify risk factors for different pregnancy outcomes.

Methods: A retrospective cohort study was conducted on 112 preterm pregnant women treated at Maanshan Maternal and Child Health Care Hospital from January 2022 to December 2023. Patients were divided into an observation group (n = 60) receiving allylestrenol tablets (10 mg daily, reduced to 5 mg after contractile reaction disappeared) and ritodrine injection (100 mg in 500 mL sedative, infused at 0.05-0.35 mg/min for 12-18 hours), and a control group (n = 52) treated with magnesium sulfate injection. Measured outcomes included symptom score, gestational age at delivery, treatment efficacy, adverse reactions, blood magnesium (MG), serum progesterone-induced blocking factor (PIBF), interleukin-6 (IL-6), cervical length (CL), and fetal fibronectin (fFN) levels.

Results: The observation group had a significantly higher effective rate (78%) compared to the control group (54%, χ² = 9.73, P = 0.008). Adverse events occurred in 8% of the observation group versus 27% in the control group (χ² = 6.41, P = 0.011). Post-treatment symptom scores were lower in the observation group, with reduced preterm birth rates, higher gestational age, and increased neonatal weight. Premature births were associated with elevated IL-6 and fFN, reduced PIBF and CL, and lower MG levels. Logistic regression revealed higher PIBF reduced preterm birth risk, while increased IL-6 and fFN heightened the risk. ROC analysis identified PIBF as the best predictor of preterm birth.

Conclusions: Allylestrenol combined with ritodrine is effective for managing preterm labor due to preeclampsia, improving maternal and fetal outcomes with good safety. This treatment warrants further clinical application.