Objective: To observe the fetal protection effect of atosiban and phloroglucinol, and their influences on coagulation function in puerperae with threatened premature delivery. Methods: A total of 104 puerperae with threatened premature delivery admitted to the Third Affiliated Hospital of Zhengzhou University were retrospectively analyzed between March 2023 and March 2025, including 56 cases treated with atosiban in group A and 48 cases treated with phloroglucinol in group B. The fetal protection effect, fetal situation, coagulation function and incidence of complications were compared between the two groups. Results: After treatment, there was no significant difference in success rate of fetal protection between the two groups (P>0.05), but full-term delivery rate and the duration of prolonged pregnancy in group A were significantly higher than those in group B (P<0.05). After delivery, there was no significant difference in the incidence of fetal cerebral hemorrhage, feeding intolerance and infection, and Apgar score between the two groups (P>0.05). After treatment, prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) in group A were significantly shorter than those in group B, while fibrinogen (FIB) was significantly higher than that in group B (P<0.05). During pregnancy and delivery, there was no significant difference in the incidence of premature rupture of membranes and gestational diabetes mellitus between the two groups (P>0.05). The incidence of postpartum hemorrhage in group A was significantly lower than that in group B, while incidence of gestational hypertension was significantly higher than that in group B (P<0.05). Conclusion: Both atosiban and phloroglucinol have good fetal protection effect. However, atosiban has longer action duration and can more effectively reduce the occurrence of premature delivery. There is no significant difference in the effects on fetal situation between the two drugs, but there are differences in the effects on coagulation function. Atosiban can effectively improve postpartum hemorrhage, while phloroglucinol can reduce the occurrence of gestational hypertension. The two drugs have their own advantages.