In which preterm labor-patients is intravenous maintenance tocolysis effective?

Satoshi Yoneda, Noriko Yoneda, Kaori Fukuta, Tomoko Shima, Akitoshi Nakashima, Arihiro Shiozaki, Osamu Yoshino, Mika Kigawa, Taketoshi Yoshida, Shigeru Saito*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Aim: We evaluated whether maintenance tocolysis (intravenous ritodrine hydrochloride and/or magnesium sulfate) was effective in cases of spontaneous preterm labor with intact membranes. Methods: One hundred and thirty preterm labor patients who reached 36 weeks of gestation by maintenance tocolysis were selected. Immediate delivery (ID) after ceasing maintenance tocolysis was defined as an ‘effective case’. The correlated factors between ID and no immediate delivery (NID) were statistically analyzed. Results: Thirty-six patients delivered < two days after ceasing maintenance tocolysis (27.7%) and were defined as effective cases. Multiple logistic regression analysis revealed that amniotic fluid interleukin-8 at admission (≥ 2.3 ng/mL; odds ratio [OR] 5.6, 95% confidence interval [CI] 2.1–17.6; P < 0.001), pre-pregnancy body mass index (≤ 21.4; OR 5.3, 95% CI 2.0–16.2; P < 0.001) and cerclage (OR 3.6, 95% CI 1.1–11.8; P = 0.028) were independent factors correlated with ID (< 2 days). Conclusion: Maintenance tocolysis may be effective in limited cases with mild intra-amniotic inflammation, in lean women and in cerclage cases. Maintenance tocolysis should be ceased in cases without these clinical factors when clinical symptoms disappear.

Original languageEnglish
Pages (from-to)397-407
Number of pages11
JournalJournal of Obstetrics and Gynaecology Research
Volume44
Issue number3
DOIs
StatePublished - 2018/03

Keywords

  • amniotic fluid interleukin-8
  • body mass index
  • cerclage
  • maintenance tocolysis
  • preterm labor

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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