Atosiban Tablet

1. Inhibit uterus contractions and prolong gestational age

By blocking oxytocin receptors and inhibiting uterus smooth muscle contractions, premature birth can be slowed down or prevented. Clinical trials have shown that in patients with threatened preterm birth between 24 and 33 weeks of pregnancy, uterus contraction frequency can be significantly reduced, pregnancy time can be prolonged, and precious time can be bought for fetal development in the mother's body. For example, the international multicenter randomized double-blind trial (APOSTEL 8) showed that there was no significant difference in perinatal mortality and neonatal severe disease incidence between patients with atosiban at 30 to 33+6 weeks of pregnancy and the placebo group. However, the treatment group extended the average pregnancy time by several days to several weeks, significantly improving fetal survival rate.

This mechanism of action provides an important means for the treatment of premature birth, especially for elderly patients with threatened premature birth. Its success rate of preserving the fetus and natural delivery rate are significantly higher than traditional uterus contraction inhibitors (such as ritodrine hydrochloride), and the incidence of adverse reactions is lower.

2. Improve maternal and infant prognosis
Its use can reduce the birth rate of premature infants, thereby reducing complications related to premature birth, such as respiratory distress syndrome, intracranial hemorrhage, etc.

By prolonging pregnancy time, fetal pulmonary surfactant synthesis increases, lung maturity improves, and the risk of neonatal respiratory distress syndrome is significantly reduced. In addition, it has little impact on the maternal cardiovascular system, which is suitable for pregnant women with heart disease or diabetes, and further improves the prognosis of mothers and infants. For example, in patients at risk of premature birth between 24 and 33 weeks of pregnancy, the combination therapy with glucocorticoids (such as dexamethasone) can significantly reduce the incidence of neonatal respiratory distress syndrome and reduce maternal cardiovascular side effects.

3. Treatment advantages in special circumstances

It has significant therapeutic advantages in special cases such as twin pregnancy, pregnancy complicated with heart disease, hyperthyroidism, hypertension, kidney disease, etc. It has fewer cardiovascular side effects and higher safety, and can be used as an alternative to traditional uterus contraction inhibitors such as beta agonists. For example, for pregnant women with concomitant heart disease, adverse reactions such as increased heart rate and elevated blood sugar caused by traditional medications can be avoided, reducing treatment risks. In addition, it can also be used for fetal preservation treatment in special situations such as premature rupture of membranes and fetal growth restriction, but the benefits and risks need to be strictly evaluated.

1. Inhibit uterus contractions and improve the success rate of embryo transfer
In assisted reproductive technology, especially before and after embryo transfer, some women may experience abnormal uterus contractions, which interfere with the positioning, adhesion, and implantation process of the embryo on the endometrium, thereby reducing the success rate of implantation. By competitively blocking oxytocin receptors, atosiban tablet effectively inhibits uterus smooth muscle contraction, keeping the uterus in a relatively quiet and stable state, creating a favorable environment for embryo transfer. In clinical applications, it is usually used before embryo transfer surgery to prevent uterus contractions induced by the transfer operation.

And continued to be used for a period of time after transfer to maintain a quiet state of the uterus and provide a time window for embryo implantation. For example, studies have shown that the use of atosiban in patients with repeated transplant failures can significantly improve clinical pregnancy rates and live birth rates, and improve clinical outcomes.

2. Improve endometrial receptivity
It may improve endometrial receptivity and increase embryo implantation rate by inhibiting uterus contractions and increasing endometrial blood flow perfusion. Endometrial receptivity refers to the ability of the endometrium to accept embryos and is a key factor for successful embryo implantation.

By reducing the mechanical interference caused by uterus contractions, the endometrium is placed in a more suitable state for embryo implantation. For example, clinical observations have found that using it before embryo transfer can significantly increase endometrial thickness and morphology scores, and increase the probability of embryo implantation.

3. Application indications for special populations
The application of assisted reproductive technology has clear indications and is usually used for patients with a history of repeated transplant failures.

Frequent uterus contractions indicated by ultrasound monitoring, or difficulties in transplant procedures. For patients undergoing first-time transplantation without obvious signs of uterus contractions, there may not be any additional benefits. In addition, its use must strictly follow the protocol of the Reproductive Medicine Center, usually administered intravenously to ensure that the medication takes effect quickly. For example, injecting atosiban half an hour before in vitro transfer can significantly improve embryo implantation rate, but the dosage and medication time need to be adjusted according to the specific situation of the patient.

1. Treatment of endometriosis and uterus fibroids
Some believe that by inhibiting uterus contractions, pain and bleeding caused by endometriosis and uterus fibroids may be reduced. Endometriosis refers to the appearance of endometrial tissue outside the uterus body, causing symptoms such as dysmenorrhea and increased menstrual flow; Uterus fibroids are benign tumors formed by the proliferation of smooth muscle tissue in the uterus, which can also cause menstrual abnormalities and abdominal pain. By inhibiting uterus contractions, these symptoms may be alleviated, but there is currently a lack of large-scale clinical trial support.

For example, some case reports have shown that it can significantly reduce menstrual flow and alleviate dysmenorrhea symptoms in patients with endometriosis, but further research is needed to verify its efficacy and safety.

2. Prevention of endometritis and cervicitis
It is possible to prevent endometritis and cervicitis by inhibiting uterus contractions and reducing the risk of retrograde infection caused by intrauterine procedures. Endometritis refers to inflammation caused by endometrial infection, while cervicitis refers to inflammation of the cervix, both of which can affect embryo implantation and pregnancy maintenance.

By maintaining a quiet state of the uterus, the risk of endometrial damage and infection caused by intrauterine procedures such as embryo transfer may be reduced. For example, clinical observations have found that using it before embryo transfer can significantly reduce the incidence of postoperative endometritis and improve pregnancy success rate, but further research is needed to confirm its preventive effect.

3. New uses in exploratory research
With further research on the mechanism of action of atosiban, new uses may be discovered in regulating uterus blood flow and improving placental function in the future.

For example, the binding effect with vasopressin V1A receptor may provide new research ideas for its regulation of uterus blood flow and improvement of placental perfusion. In addition, the application of atosiban in special situations such as multiple pregnancies and pregnancy complicated with internal medicine diseases also needs further exploration. For example, pregnant women with multiple pregnancies need to carefully evaluate the benefits and risks of using it, and those with renal insufficiency need to adjust the dosage. Currently, there is a lack of sufficient evidence to support atosiban tablet routine use in women with pregnancy or premature rupture of membranes after 34 weeks.