engleski

Oral maintenance ritodrine tocolysis after active pre term labor: randomized controlled trial

Aim: To assess the efficacy of oral ritodrine in the form of sustained release capsules for maintenance of uterine quiescence after successful treatment of threatened preterm labor. Methods: One hundred and twenty women with singleton pregnancy and successfully treated threatened preterm labor (PTL) before 34 completed weeks were randomized to receive maintenance tocolysis with two 40 mg ritodrine sustained release capsules three times a day (study group, n=62) or no treatment (control group, n=58) for three days. The primary outcome measure was the recurrent episode of threatened PTL within 72 hours defined as regular palpable uterine contractions and the change in cervical effacement and/or dilatation on clinical examination. Secondary outcome measures included the incidence of preterm birth, neonatal adverse outcomes and maternal side effects. Results: There was no difference in the frequency of recurrent episode of threatened PTL requiring another course of intravenous treatment comparing study and control group (8/62 vs 6/58, RR=0.81, 96%CI 0.30-2.21, P=0.879). No differences was found in any of the predefined secondary outcome measures (delivery before 37 weeks, 13/62 vs 7/58, RR=0.57, 95%CI 0.25-1.34, P=0.288 ; delivery before 34 weeks, 3/62 vs 1/58, RR=0.57, 95%CI 0.04-3.33, P=0.682 and birth weight, 3035 &plusmn ; 573g vs 3223 &plusmn ; 423g, p=0.862). There were more reported maternal side effects in the study group (47/62 vs 23/58, P< 0.001). Conclusions: There is no need for additional maintenance ritodrine therapy in singleton pregnancy for women who have an episode of threatened PTL and are successfully treated with intravenous tocolytic therapy.

preterm labor; oral tocolytics; maintenance dose

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