title: Does indomethacin prevent preterm birth in women with cervical dilatation in the second trimester?
abstract: We sought to estimate the effect of indomethacin on duration of pregnancy in women with dilated cervix between 14 (0)/ (7) to 25 (6)/ (7) weeks. Demographics, risk factors, and outcomes were compared in women 14 (0)/ (7) to 25 (6)/ (7) weeks with a dilated cervix > or = 1 cm who received indomethacin versus no indomethacin therapy, stratified for cerclage. Primary outcome was interval from presentation until delivery. Of 222 singleton gestations, 68 (31%) received indomethacin. In unadjusted and adjusted analyses, no significant differences were observed in interval from presentation to delivery and preterm birth < 28, < 32, or < 35 weeks comparing the indomethacin and no indomethacin groups, even after stratification for cerclage. In multivariate logistic regression analysis limited to women receiving cerclage, preterm birth < 32 weeks (odds ratio 0.56, 95% confidence interval 0.26, 1.25) and < 35 weeks (odds ratio 0.52, 95% confidence interval 0.23, 1.14) suggested a possible but not significant benefit for indomethacin use. Indomethacin therapy in women with dilated cervix at 14 (0)/ (7) to 25 (6)/ (7) weeks, regardless of cerclage or not, had no effect on pregnancy outcomes.
authors.affiliation: Departments of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. vincenzo.berghella@jefferson.edu
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Berghella
authors.forename: Witoon
authors.initials: W
authors.lastname: Prasertcharoensuk
authors.forename: Amanda
authors.initials: A
authors.lastname: Cotter
authors.forename: Juha
authors.initials: J
authors.lastname: Rasanen
authors.forename: Suneeta
authors.initials: S
authors.lastname: Mittal
authors.forename: Surasith
authors.initials: S
authors.lastname: Chaithongwongwatthana
authors.forename: Ricardo
authors.initials: R
authors.lastname: Gomez
authors.forename: Etaoin
authors.initials: E
authors.lastname: Kearney
authors.forename: Jorge E
authors.initials: JE
authors.lastname: Tolosa
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pereira
mesh_terms: D000328:Adult; D000649:Amniocentesis; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001724:Birth Weight; D023802:Cerclage, Cervical; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D007213:Indomethacin / Q000627:therapeutic use*; D007231:Infant, Newborn; D007747:Labor Stage, First / Q000187:drug effects*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second / Q000187:drug effects*; D047928:Premature Birth / Q000517:prevention & control*; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use; D013997:Time Factors; D015149:Tocolytic Agents / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D013256:Steroids; D015149:Tocolytic Agents; D007213:Indomethacin