Inflammatory and infectious risk factors are associated with the response to tocolysis in patients with preterm labor.
OBJECTIVE
Inflammation/infection is the most frequent conditions leading to preterm delivery (PTD). A few studies have assessed the clinical efficacy of long-term tocolysis with ritodrine hydrochloride. In this study, the relationship among inflammatory/infective risk factors of PTD, the response to long-term tocolysis, and timing of delivery were evaluated in women with preterm labor.


METHODS
On the basis of different responses to long-term tocolysis, defined as ≥ 7 days tocolysis, the cohort were classified as: (i) patients delivering at term (Group A) and (ii) patients delivering preterm (group B). Group B was subclassified as: (i) delivery before 48 h (group B1); (ii) delivery between 48 h and 7 days (Group B2), and (iii) delivery after 7 days (Group B3). Group B is divided in early preterm (<32 weeks) (Group B early) and late PTD (32-36 weeks) (Group B late).


RESULTS
Group A delivered at term and Group B preterm. Group B showed significantly higher (p < 0.0001) rate of CRP, bacterial vaginosis, and chorioamnionitis at placental histological examination than Group A. The same parameters were statistically higher (p < 0.0001) in group B1 than in B3. CRP, chorioamnionitis at placental histological examination was statistically higher (p < 0.0001) in Group B early than in Group B late.


CONCLUSIONS
This retrospective study suggested that in women affected by preterm labor, the long-term tocolysis with intravenous ritodrine is able to prolong gestation beyond 7 days, in absence of inflammatory/infective risk factors of PTD.
Torricelli
Michela
M
Department of Pediatrics, University of Siena, Siena, Italy.
Voltolini
Chiara
C
Conti
Nathalie
N
De Bonis
Maria
M
Biliotti
Giulia
G
Picciolini
Enrico
E
Petraglia
Felice
F
D000328:Adult; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000188:drug therapy / Q000276:immunology*; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D012312:Ritodrine / Q000627:therapeutic use*; D013997:Time Factors; D015145:Tocolysis; D015149:Tocolytic Agents / Q000627:therapeutic use*; D016896:Treatment Outcome
D015149:Tocolytic Agents; D012312:Ritodrine