ABSTRACT
Ritodrine hydrochloride and magnesium sulfate used in combination for preterm labor
tocolysis have been cited for yielding excessively high complication rates. A retrospective
chart review was performed to assess the frequency of these complications and to determine
whether tocolysis can be continued despite complications. Of 95 patients managed with
dual tocolytics, 61 had side effects sufficiently serious to warrant cessation of
tocolytic therapy for an overall complication rate of 64%. After evaluation for objective
evidence of pathologic conditions, 41 (67%) patients were restarted on dual tocolytics
without further complication. It was deemed inappropriate to restart tocolysis in
20 patients, resulting in a 21% rate of complications. This allowed a significant
increase in the number of patients delivering after 36 weeks (19.5% versus 50%, p
< 0.02) and a decrease in neonatal intensive care unit days per infant (3 versus 15.5
days, p < 0.02). This suggests that aggressive continued tocolysis with multiple agents
can be safe and efficacious with appropriate evaluation.
