Document Detail

Management of recurrent preterm labor in twin gestations with nifedipine tocolysis.
MedLine Citation:
PMID:  18773381     Owner:  NLM     Status:  MEDLINE    
We examined outcomes of twin pregnancies complicated by recurrent preterm labor receiving nifedipine tocolysis. In a retrospective study design, twin pregnancies receiving outpatient preterm labor surveillance services and oral nifedipine tocolysis following a diagnosis of preterm labor were identified from a database ( N = 1421). Eligible for inclusion were patients subsequently rehospitalized with recurrent preterm labor symptoms ( N = 862). Included were patients at < 35 weeks' gestation, having intact membranes, and remaining undelivered for > 48 hours after recurrent preterm labor ( N = 656). Pregnancy outcomes of women resuming nifedipine tocolysis ( N = 418) following hospitalization were compared with those having an alteration in treatment ( N = 238) to continuous subcutaneous terbutaline. Alteration of tocolytic treatment versus resuming nifedipine resulted in increased pregnancy prolongation (34.7 +/- 18.8 days versus 27.5 +/- 19.9 days, P < 0.001), with delivery of fewer low birth weight (67.2% versus 78.3%, P < 0.001) and very low birth weight infants (6.5% versus 15.0%, P < 0.001) and a decreased incidence of neonatal intensive care unit admission (44.7% versus 52.9%, P = 0.005). In twin pregnancies receiving nifedipine tocolysis, alteration of tocolytic treatment to subcutaneous terbutaline following hospitalization for recurrent preterm labor symptoms had a positive impact on pregnancy prolongation and neonatal outcomes.
Lesley de la Torre; Niki B Istwan; Cheryl Desch; Debbie J Rhea; Luis Roca; Gary J Stanziano; Víctor Hugo González-Quintero
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-09-04
Journal Detail:
Title:  American journal of perinatology     Volume:  25     ISSN:  1098-8785     ISO Abbreviation:  Am J Perinatol     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-31     Completed Date:  2009-01-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8405212     Medline TA:  Am J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  555-60     Citation Subset:  IM    
Department of Obstetrics and Gynecology, University of Miami, Miami, Florida 33101, USA.
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MeSH Terms
Administration, Oral
Dose-Response Relationship, Drug
Drug Administration Schedule
Gestational Age
Injections, Subcutaneous
Nifedipine / therapeutic use*
Obstetric Labor, Premature / drug therapy*,  prevention & control
Pregnancy Outcome*
Pregnancy, Multiple*
Recurrence / prevention & control
Retrospective Studies
Risk Assessment
Terbutaline / therapeutic use*
Term Birth
Tocolysis / methods
Tocolytic Agents / therapeutic use*
Treatment Outcome
Reg. No./Substance:
0/Tocolytic Agents; 21829-25-4/Nifedipine; 23031-25-6/Terbutaline

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