title: Management options in women with preterm uterine contractions: a randomized clinical trial.
abstract: OBJECTIVE
  Our purpose was to evaluate three management strategies and to assess pregnancy outcomes in women with preterm uterine contractions.
  
  
  METHODS
  Consenting women seen in our hospital triage area with preterm uterine contractions were randomly assigned to observation alone, intravenous hydration, or one dose of subcutaneous terbutaline sulfate (0.25 mg). Eligible women had a singleton gestation between 20 and 34 weeks, intact membranes, more than three contractions in 30 minutes, and a cervical dilation < or = 1 cm and effacement < 80%. Women who had progressive cervical change at < 34 weeks were treated with intravenous tocolysis. Women with recurrent preterm uterine activity remained in their assigned group during subsequent triage visits.
  
  
  RESULTS
  One hundred seventy-nine women were randomized: observation (56), hydration (62), and terbutaline (61). Women in these three groups were similar with respect to maternal age, race, parity, prior preterm births, gestational age at randomization, contraction frequency, and mean cervical dilatation. There were no intergroup differences in the mean days to delivery, the number of repeat triage visits, the incidence of preterm labor at < 34 weeks, or the frequency of preterm deliveries at < 34 weeks and < 37 weeks. Women assigned to terbutaline had contractions stopped and were discharged earlier (terbutaline 4.1 +/- 5.1 hours, observation 5.2 +/- 5.3 hours, hydration 6.0 +/- 5.7 hours; p = 0.006). No complications of therapy were observed.
  
  
  CONCLUSIONS
  The use of intravenous hydration in the management of preterm contractions was of no benefit. The use of one dose of subcutaneous terbutaline resulted in the shortest length of triage stay but did not affect pregnancy outcome.
authors.affiliation: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Guinn
authors.forename: A R
authors.initials: AR
authors.lastname: Goepfert
authors.forename: J
authors.initials: J
authors.lastname: Owen
authors.forename: C
authors.initials: C
authors.lastname: Brumfield
authors.forename: J C
authors.initials: JC
authors.lastname: Hauth
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005440:Fluid Therapy; D005865:Gestational Age; D017048:Health Care Costs; D006801:Humans; D007752:Obstetric Labor, Premature / Q000191:economics / Q000628:therapy*; D011247:Pregnancy; D013726:Terbutaline / Q000627:therapeutic use; D015149:Tocolytic Agents / Q000627:therapeutic use; D014590:Uterine Contraction
chemical_list: D015149:Tocolytic Agents; D013726:Terbutaline