Efficacy of aggressive tocolysis for preterm labor with advanced cervical dilatation.
OBJECTIVE
Study the effectiveness of tocolysis for preterm labor with advanced cervical dilatation ( > or = 3 cm) to achieve sufficient latency for the effect of steroids to occur, and delivery of more mature neonates.


METHODS
We studied 249 singleton pregnancies, 23-36 weeks gestation in preterm labor, stratified by weeks of gestation and degree of cervical dilatation (Group A: 117, < 3 cm; Group B: 132, 3 cm) who were given tocolysis and compared for the length of latency and neonatal outcome.


RESULTS
Maternal characteristics were similar between groups except African-American women were admitted with more advanced cervical dilatation. Latency 72 hours was achieved in Group A: > 75% at all gestational ages, and Group B: > 50%. Latency > or = 72 hours, according to the degree of cervical dilatation, was for Group A: 90%, for Group B: 50-75% from > 3-5 cm dilatation, and 40% at 5.1-6 cm dilatation. Neonatal morbidity was mild with a decreased risk of long-term disability.


CONCLUSIONS
Aggressive tocolytic therapy for preterm labor with advanced cervical dilatation is efficacious, allows for steroid therapy, and allows delivery of more mature neonates.
Psomiadis
Nicolas
N
Department of Obstetrics and Gynecology, Memorial Health University Medical Center, Savannah, GA 31401, USA.
Goldkrand
John
J
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use; D007231:Infant, Newborn; D007234:Infant, Premature; D007747:Labor Stage, First; D008278:Magnesium Sulfate / Q000627:therapeutic use; D007752:Obstetric Labor, Premature / Q000188:drug therapy*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D013997:Time Factors; D015145:Tocolysis; D015149:Tocolytic Agents / Q000627:therapeutic use*
D000305:Adrenal Cortex Hormones; D015149:Tocolytic Agents; D008278:Magnesium Sulfate; D007213:Indomethacin