Magnesium Sulfate Tocolysis in Selected Patients with Symptomatic Placenta Previa

Watson, William J.; Cefalo, Robert C.

doi:10.1055/s-2007-999493

Cited by 13 publications

(2 citation statements)

References 5 publications

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“…It does not appear to be associated with an increase in both maternal and fetal morbidity and mortality [15] and has been reported to be better than beta-sympathomimetics for patients with placenta previa having uterine contractions and a mild degree of bleeding [16]. Nifedipine has also been advocated as a safe and effective tocolytic agent, but its value in APHUO needs further evaluation [17].…”

Section: Discussionmentioning

confidence: 99%

Risk and Prediction of Preterm Delivery in Pregnancies Complicated by Antepartum Hemorrhage of Unknown Origin before 34 Weeks

Leung

Chan²,

Tam³

et al. 2001

Gynecol Obstet Invest

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Objective: To assess the timing and risk factors of preterm delivery in pregnancies complicated by antepartum hemorrhage of unknown origin (APHUO) before 34 weeks of gestation, and to formulate a clinical management protocol. Methods: A retrospective study involving singleton pregnancies with APHUO occurring before the 34th week of gestation was performed over a 4-year period at a university teaching hospital. Results: Seventy-five cases were identified. Fifty-nine (78.7%) did not have any associated uterine contractions, 74.7 and 90.7% of the cases were classified as having mild bleeding according to history and physical examination, respectively. The number of cases delivering before 37 weeks of gestation and before 34 weeks were 28 (37.3%) and 22 (29.3%), respectively. Eighteen cases (24%) delivered within the first week of APHUO, and 4 (5.3%) within the first day. The number of cases delivering within the first week was significantly higher when there were uterine contractions (62.5 vs. 13.6%, p < 0.001). The severity of bleeding was not shown to be related to the time of delivery. Conclusion: APHUO that occurs before 34 weeks is associated with a high risk of preterm delivery before 34 weeks (29.3%). The chance of delivery within the first week is 62.5% when there are coexisting uterine contractions. Even if contractions are absent, the risk is still high (13.6%) and persists beyond the first week. We suggest that this group of patients should be managed with a course of steroid injection and hospitalization for 4 days.

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Section: Discussionmentioning

confidence: 99%

Risk and Prediction of Preterm Delivery in Pregnancies Complicated by Antepartum Hemorrhage of Unknown Origin before 34 Weeks

Leung

Chan²,

Tam³

et al. 2001

Gynecol Obstet Invest

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“…1). [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Thus, there are only three publications (one RCT and two retrospective studies) on maintenance tocolytics for preterm symptomatic placenta previa. 5,6,27 We combined the results of the retrospective studies and compared it with the RCT.…”

Section: Resultsmentioning

confidence: 99%

Maintenance Tocolytics for Preterm Symptomatic Placenta Previa: A Review

et al. 2010

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The purpose of the review article is to determine if prolonged (≥48 hour) tocolytics with symptomatic preterm placenta previa improves perinatal outcome. OVID MEDLINE and Cochrane Databases were searched from January 1950 to January 2009. Odds ratio (OR) and 95% confidence intervals (CI) were calculated. We identified two retrospective studies ( N = 217) and one randomized clinical trial (RCT; N = 60), and they were analyzed separately. Results of the RCT indicated that pregnancy is prolonged for more than 7 days with continued tocolytics (OR 3.10, 95% CI 1.38 to 6.96) but combined results of two retrospective studies did not confirm the prolongation (OR 1.19, 95% CI 0.63 to 2.28). The RCT was inadequately compliant with Consolidated Standards of Reporting Trials statement. While awaiting an appropriately designed RCT to determine the duration of tocolytics with placenta previa and preterm labor, it should be limited to 48 hours.

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