Tocolysis in Advanced Preterm Labor: Impact on Neonatal Outcome

Veciana, Margarita de; Porto, Manuel; Major, Carol; Barke, Jeffrey I.

doi:10.1055/s-2007-994478

Cited by 22 publications

(5 citation statements)

References 6 publications

(8 reference statements)

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“…These patients may require combined use of tocolytic agents like intravenous magnesium sulfate and oral indomethacin to achieve longer duration of successful tocolysis. 16,17 In summary, our study shows that women with preterm uterine contractions presenting at 1-cm dilatation are at significant risk for preterm delivery: 19/94 (20%) at < 32 weeks and 40/104 (38%) at < 35 weeks. Because the diagnosis of early preterm labor remains difficult, we recommend that patients presenting to labor and delivery with regular uterine contractions especially at < 32 weeks' gestation should be observed for at least 24 hours prior to discharge.…”

Section: Discussionmentioning

confidence: 68%

Cervical Dilatation on Presentation for Preterm Labor and Subsequent Preterm Birth

How

Sibai

2008

Amer J Perinatol

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We sought to determine the risk of preterm (< 32 weeks) delivery as it relates to cervical dilatation at presentation of an initial preterm labor admission episode. We retrospectively reviewed the records of all patients presenting with preterm contractions at 22 to 32 weeks' gestation. Multiple regression was used to analyze the relationship between the interval from initial preterm labor admission episode to delivery and cervical dilatation at presentation. Logistic regression analysis was used to identify variables associated with preterm birth. Mean gestational age on admission for preterm labor episode was 28.1 +/- 2.9 weeks. With a cervical dilatation of 0 to 1 cm, 6% of the women delivered within 48 hours, 20% delivered at < 32 weeks, and 38% delivered at < 35 weeks. With cervical dilatation of 6 to 10 cm, 89% delivered in < 24 hours, 11% between 24 and 48 hours, 94% delivered at < 32 weeks, and 100% delivered at < 35 weeks. Time from admission for initial preterm labor episode to delivery was inversely associated with cervical dilatation. Variables associated with preterm birth at < 32 weeks' gestation were cervical dilatation ( P < 0.0001), gestational age ( P < 0.0001), and effacement ( P < 0.0001) at presentation. In women who experience preterm contractions, cervical dilatation on admission is inversely related to interval to delivery. However, women with cervical dilatation of 0 to 1 cm are still at significant risk for preterm delivery: 19/94 (20%) at < 32 weeks' gestation and 40/104 (38%) at < 35 weeks' gestation.

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Section: Discussionmentioning

confidence: 68%

Cervical Dilatation on Presentation for Preterm Labor and Subsequent Preterm Birth

How

Sibai

2008

Amer J Perinatol

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“…Similar results were found in different control trials. This study shows that nifedipine is a better choice for tocolysis 16 , compared with salbutamol in view of less maternal side effects and comparable results regarding prolongation of pregnancy and neonatal outcome.…”

Section: Uterine Contractionsmentioning

confidence: 63%

Comparison of Salbutamol and Nifedipine as a Tocolytic Agent in the Treatment of Preterm Labour

2008

j liaquat uni med health sci

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“…However, data on tocolysis and advanced preterm labor are limited and the appropriate management is controversial. [ 12 13 14 ]…”

Section: Discussionmentioning

confidence: 99%

Relationship between cervical dilation and time to delivery in women with preterm labor

et al. 2015

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Background:Early recognition of the signs and symptoms of preterm labor (PTL) is important in order to establish treatment. Our aim was to determine the relation between cervical dilatation and time interval from admission to delivery in women with preterm labor.Materials and Methods:A retrospective cohort study was conducted on 83 singleton gestations admitted for preterm labor between 24 weeks and 34 weeks, who subsequently delivered preterm. Women were categorized into three groups of cervical dilatation (0-2 cm, 3-6 cm, >6 cm) and the time interval from admission to delivery was compared. Cox regression analysis was performed to assess the association between cervical dilatation and time interval from admission to delivery. The other variables examined were gestational age (GA) at admission and length of the cervix, when performed.Results:The time interval from admission to delivery was significantly shorter in women with higher dilatation of the cervix (p < 0.02) and in those admitted at a more advanced gestational age (p < 0.05). Forty-eight percent of women with cervical dilatation 0-2 cm delivered in the first 48 h compared to 85% of the women with a dilatation of 3-6 cm. No significant association was found between the length of the cervix and the time interval to delivery.Conclusion:Dilatation of the cervix and gestational age at admission are associated with the time interval to delivery in women with preterm labor. The assessment of the length of the cervix is unlikely to add clinical information in women with an already dilated cervix.

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Tocolysis in Advanced Preterm Labor: Impact on Neonatal Outcome

Cited by 22 publications

References 6 publications

Cervical Dilatation on Presentation for Preterm Labor and Subsequent Preterm Birth

Cervical Dilatation on Presentation for Preterm Labor and Subsequent Preterm Birth

Comparison of Salbutamol and Nifedipine as a Tocolytic Agent in the Treatment of Preterm Labour

Relationship between cervical dilation and time to delivery in women with preterm labor

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