Efficacy of aggressive tocolysis for preterm labor with advanced cervical dilatation

Abstract

Objective. Study the effectiveness of tocolysis for preterm labor with advanced cervical dilatation ( ⩾ 3 cm) to achieve sufficient latency for the effect of steroids to occur, and delivery of more mature neonates.Study design. We studied 249 singleton pregnancies, 23–36 weeks gestation in preterm labor, stratified by weeks of gestation and degree of cervical dilatation (Group A: 117, < 3 cm; Group B: 132, ⩾ 3 cm) who were given tocolysis and compared for the length of latency and neonatal outcome.Results. Maternal characteristics were similar between groups except African-American women were admitted with more advanced cervical dilatation. Latency ⩾ 72 hours was achieved in Group A: > 75% at all gestational ages, and Group B: > 50%. Latency > 72 hours, according to the degree of cervical dilatation, was for Group A: 90%, for Group B: 50–75% from > 3–5 cm dilatation, and 40% at 5.1–6 cm dilatation. Neonatal morbidity was mild with a decreased risk of long-term disability.Conclusions. Aggressive tocolytic therapy for preterm labor with advanced cervical dilatation is efficacious, allows for steroid therapy, and allows delivery of more mature neonates.