ABSTRACT
To determine whether hospital admission and parenteral tocolysis of patients with
threatened preterm labor results in a decreased preterm delivery rate and improved
perinatal outcome, we performed a prospective cohort study comparing tocolytic treatment
versus no tocolytic treatment. Women between 20 and 37 weeks' gestation who presented
with at least eight uterine contractions per hour and a cervical examination <2 cm
dilated, <80% effaced, and no cervical change over a 2-hr period were entered into
the study. Exclusion criteria included cervical change, multiple gestation, chorioamnionitis,
rupture of membranes, placenta previa or abruption, undiagnosed vaginal bleeding,
and prior tocolytic therapy in the current pregnancy. Seventy-five patients were admitted
to the hospital for tocolysis (tocolysis cohort) and 81 were observed and discharged
to home (observation cohort). There was no significant difference in mean gestational
age at delivery, mean birth weight, or in preterm delivery rate between the two cohorts.
Four of the eight women in the observation cohort who delivered preterm had a history
of preterm delivery. We conclude that discharging women with preterm contractions
without objective evidence of labor does not result in an increase in preterm births.
More importantly, tocolysis did not decrease the preterm delivery rate in this cohort.
Keywords
Preterm labor - diagnosis - tocolysis - preterm delivery
