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Survey of the management of preterm labour in Australia and New Zealand in 2002
Author(s) -
Cook ColleenM.,
Peek Michael J.
Publication year - 2004
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.2004.00173.x
Subject(s) - medicine , nifedipine , preterm labour , pregnancy , gestation , obstetrics , tocolytic agent , preterm labor , biology , genetics , calcium
Aim: To determine current attitudes and practices regarding the suppression of preterm labour among obstetricians in Australia and New Zealand. Methods: A questionnaire mailed to all Diplomates, Members and Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists in April 2002. Results: A total of 813 surveys were returned – 33% (470/1412) of Fellows and Members and 11% (322/2806) of Diplomates. The response rate for Australia was 18.9% (759 of 4019) compared to 27.1% (54 of 199) from New Zealand. Routine suppression of preterm labour was attempted by 79% of respondents, primarily to prolong pregnancy for steroid administration (83%) and/or transfer (74%). The gestation for initiation of suppression ranged from 20 to 37 weeks. Tocolysis was discontinued at 32.9 ± 2.7 weeks (mean ± SD), range 24–38 weeks. The first choice drug for tocolysis was the β‐adrenergic group (73%), followed by nifedipine (21%). Maintenance tocolysis was used by 34%. Respondents were asked the percentage of women in whom suppression was attempted that achieved: (i) steroid cover – median 80% (range 10–100); (ii) prolongation of pregnancy ≥7 days – 50% (0–100); and (iii) prolongation of pregnancy to term – 10% (0–100). Conclusion: Most respondents attempted to suppress preterm labour for steroid administration and/or transfer. However, a wide range of opinions and uncertainty was evident as to the effectiveness of tocolytic therapy in clinical management, the most appropriate drug and drug side‐effects.