[Studies of the clinical effectiveness of intravenous long-term tocolysis].

Possible retardation of delivery following different periods of intravenous Partusisten tocolysis was studied in 701 premature births, between the 28th and 36th weeks of pregnancy. The studies were conducted separately, for all probands together and by gestational age groups. Various symptoms of imminent premature birth were not weighed. The rate of failure amounted to 23 per cent, that is delivery occurred within 24 hours from beginning of treatment. Extension of pregnancy by something between two and seven days was achieved in 45 per cent of the probands or by more than seven days in 32 per cent. Growing length of intravenous tocolysis was followed by significant rise in the number of women with genuine prolongation of pregnancy (between eight and 28 days or even more), however, without any unambiguous evidence to differentiation between gestational age groups with regard to therapeutic responsiveness. Significant percentual rise in prematurity between the 34th and 36th weeks of pregnancy by almost 30 per cent (with 20 per cent in the 36th week of pregnancy alone) seems to indicate a measurable clinical benefit of intravenous long-term tocolysis in terms of higher life expectancy and better survival quality. --The above findings were compared with results that had been obtained from 1,037 prematurely born infants of the same gestational age groups without preceding tocolysis. The conclusion was that intravenous tocolysis in general and long-term tocolysis in particular failed to have the slightest negative impact in terms of acidosis and RDS morbidity, average birth weight, hypotrophy, and survival chance. The need for properly timed detection of prematurity as part of routine care may be seen from the great number of untreated premature births, that is cases beyond any possibility of treatment. The point is made that the effectiveness of tocolytic therapy can be measured only by those premature newborns who had received treatment rather than by the totality of premature newborns.