This study by Lorthe et al. (AJOG, 2017) explores if tocolytic therapy following preterm PROM (PPROM) is associated with improved neonatal or obstetric outcomes.
Multi-center, prospective, population-based cohort study
803 women with PPROM at 24-32 weeks’ gestation and singleton pregnancies were included in the study. 73.45% patients received tocolysis. There was no difference in neonatal survival without severe morbidity between women who received tocolysis and those who did not (86.7% vs. 83.9% respectively). When adjusting for confounders, primarily bias due to indication for treatment, tocolysis was not associated with increase survival without severe morbidity (odds ratio, 1.01 [95% CI 0.94-1.09]), latency of ≥48 hours to delivery (1.03 [95% CI 0.95-1.11]), or histological chorioamnionitis (1.03 [95% CI 0.92-1.17]). The choice of tocolytic medication (oxytocin receptor antagonists or calcium-channel blockers) had no impact on outcomes. The authors conclude that at present, there does not appear to be any clinical benefit for the use of tocolytic drugs in the setting of PPROM.
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