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Method to evaluate intravenous maintenance tocolysis for preterm labor
Author(s) -
Yoneda Satoshi
Publication year - 2020
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.14484
Subject(s) - medicine , neonatal intensive care unit , fetal fibronectin , gestation , gestational age , amniotic fluid , intensive care unit , obstetrics , group b , preterm labor , white blood cell , pregnancy , fetus , anesthesia , pediatrics , biology , genetics
Abstract Aim Despite the lack of evidence‐based medicine, continuous intravenous maintenance tocolysis is the main treatment for preterm labor (PTL) in Japan because it is considered to prolong the gestational period. This treatment needs to be evaluated in more detail, and we herein propose one method to assess maintenance tocolysis using the timing of delivery by PTL patients. Methods PTL patients ( n = 307) were divided into three groups according to delivery weeks of gestation. Group A (severe PTL) delivered at <34 weeks, group B (mild PTL) at 34–37 weeks and group C (cases suspected overtreatment) at ≥38 weeks. The percentages of patients in each group was calculated and clinical characteristics were compared between groups. Results The percentages of patients (%) in groups A, B and C were 33.9, 43.6 and 22.5, respectively. Gestational weeks on admission, maternal white blood cell count and C‐reactive protein, PTL index, fetal fibronectin levels in vaginal secretions, amniotic fluid interleukin‐8 levels, staying at neonatal intensive care unit were significantly different between these three groups by analysis of variance. Furthermore, amniotic fluid interleukin‐8 levels were significantly higher in group B (3.5 [0.1–46.5] ng/mL) than in group C (1.7 [0.1–16.1], P < 0.05). Conclusions PTL patients were classified according to the prognosis. The ratio of patients in each group represented the severity of PTL and the risk of overtreatment. When this ratio is investigated on a nationwide scale, the use of intravenous maintenance tocolysis or definition of PTL may need to be reconsidered.