The clinical efficacy of oral tocolytic therapy.
Publication/Presentation Date
10-1-1996
Abstract
OBJECTIVE: Our purpose was to determine whether maintenance oral tocolytic therapy after preterm labor stabilization decreases uterine activity, reduces the rate of recurrent preterm labor and subsequent preterm birth, or improves neonatal outcome.
STUDY DESIGN: Women with documented idiopathic preterm labor stabilized with acute tocolytic therapy were randomized to three groups: placebo, terbutaline 5 mg, or magnesium chloride 128 mg, all given orally every 4 hours. Patients and providers were blinded to group assignment. All subjects were enrolled in a comprehensive system of preterm birth prevention that included preterm labor education, weekly clinic visits, home uterine contraction assessment, daily phone contact, and 24-hour perinatal nurse access.
RESULTS: Of the 248 patients who were randomized, 39 were delivered before discharge and 4 were lost to follow-up, leaving 205 for final analysis: 68 placebo, 72 terbutaline, and 65 magnesium. The terbutaline group had significantly more side effects than the placebo group did. All groups had otherwise similar perinatal outcomes when confounding variables were controlled for. Overall, the three groups had a preterm birth rate < 37 weeks of 55.6% delivery, < 34 weeks of 15.6%, a 20.4% rate of newborn intensive care unit admission, and a mean neonatal length of stay of 6.3 days.
CONCLUSIONS: Maintenance oral tocolytic therapy did not decrease uterine activity, reduce the rate of recurrent preterm labor or preterm birth, or improve perinatal outcome. Overall improvement in perinatal outcome may be achieved with a comprehensive program of preterm birth prevention without the use of maintenance oral tocolytic therapy.
Volume
175
Issue
4 Pt 1
First Page
838
Last Page
842
ISSN
0002-9378
Published In/Presented At
Rust, O. A., Bofill, J. A., Arriola, R. M., Andrew, M. E., & Morrison, J. C. (1996). The clinical efficacy of oral tocolytic therapy. American journal of obstetrics and gynecology, 175(4 Pt 1), 838–842. https://doi.org/10.1016/s0002-9378(96)80009-3
Disciplines
Medicine and Health Sciences
PubMedID
8885732
Department(s)
Department of Obstetrics and Gynecology
Document Type
Article