Survey of the management of preterm labour in Australia and New Zealand in 2002.
OBJECTIVE
To determine current attitudes and practices regarding the suppression of preterm labour among obstetricians in Australia and New Zealand.


METHODS
A questionnaire mailed to all Diplomates, Members and Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists in April 2002.


RESULTS
A total of 813 surveys were returned - 33% (470/1412) of Fellows and Members and 11% (322/2806) of Diplomates. The response rate for Australia was 18.9% (759 of 4019) compared to 27.1% (54 of 199) from New Zealand. Routine suppression of preterm labour was attempted by 79% of respondents, primarily to prolong pregnancy for steroid administration (83%) and/or transfer (74%). The gestation for initiation of suppression ranged from 20 to 37 weeks. Tocolysis was discontinued at 32.9 +/- 2.7 weeks (mean +/- SD), range 24-38 weeks. The first choice drug for tocolysis was the beta-adrenergic group (73%), followed by nifedipine (21%). Maintenance tocolysis was used by 34%. Respondents were asked the percentage of women in whom suppression was attempted that achieved: (i) steroid cover--median 80% (range 10-100); (ii) prolongation of pregnancy > or =7 days--50% (0-100); and (iii) prolongation of pregnancy to term--10% (0-100).


CONCLUSIONS
Most respondents attempted to suppress preterm labour for steroid administration and/or transfer. However, a wide range of opinions and uncertainty was evident as to the effectiveness of tocolytic therapy in clinical management, the most appropriate drug and drug side-effects.
Cook
Colleen-M
CM
Department of Obstetrics and Gynaecology, University of Sydney at Nepean Hospital, Penrith, New South Wales, Australia. CookC@wahs.nsw.gov.au
Peek
Michael J
MJ
D001291:Attitude of Health Personnel; D001315:Australia; D001510:Bed Rest; D036861:Delivery, Obstetric / Q000379:methods*; D005260:Female; D005865:Gestational Age; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009520:New Zealand; D007752:Obstetric Labor, Premature / Q000175:diagnosis* / Q000628:therapy*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011256:Pregnancy Outcome; D011336:Probability; D011787:Quality of Health Care; D018570:Risk Assessment; D013256:Steroids / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D015145:Tocolysis / Q000379:methods*; D014710:Version, Fetal / Q000379:methods
D013256:Steroids