Stein W, Jahns B, Hawighorst T, Emons G
Zentrum für Frauenheilkunde der Georg-August-Universität Göttingen.
Z Geburtshilfe Neonatol. 2009 Feb;213(1):18-22. doi: 10.1055/s-0028-1119412. Epub 2009 Mar 3.
According to current recommendations tocolysis for more than 48 h is only indicated in selected cases. The aim of this study was to analyse the relevance of long-term tocolysis with beta-2-mimetics (Fenoterol) at a single centre over a period of three years.
Tocolysis was performed in the case of isolated preterm contractions in 39 cases (56.5%) and in case of premature rupture of membranes in 30 cases (43.5%).
34 cases of tocolysis (49.3%) were started at <30+0 weeks of gestation. The duration of tocolysis was <48 h in nine cases (13%), 48 h 12 cases (17.4%), 3-7 days 20 cases (29%) and >7 days 28 cases (40.6%). Neonatal complications occurred less with increasing gestational age: for <28+0 weeks six of seven infants (85.7%), for 28+0 to 29+6 weeks six of 12 infants (50%), and for 30+0 to 33+6 weeks three of 42 infants (7.1%) suffered from complications. At this single centre long-term tocolysis was performed in 18 cases (26.1%) for <28+0 and in 29 cases (42%) for <32+0 weeks of gestation.
The poor prognosis of extremely preterm infants improves rapidly with increasing gestational age, therefore long-term tocolysis should be considered as a therapeutic option in the case of an imminent birth.
