Magnesium sulfate (MGS04) tocolysis versus no tocolysis in women with preterm labor between 32 0/7 and 34 6/7 weeks of gestation: A randomized controlled trial

Abstract

WITH PRETERM LABOR BETWEEN 32 0/7 AND 34 6/7 WEEKS OF GESTATION: A RANDOMIZED CONTROLLED TRIAL HELEN HOW, LELA ZAFARANCHI, CAROLINE STELLA, KATHERINE RECHT, ROSEMAXWELL, BAHA SIBAI, JOSEPH SPINNATO II, University of Cincinnati, Obstetrics & Gynecology, Cincinnati, Ohio OBJECTIVE: To determine whether MgSO4 tocolysis in women with preterm labor between 32 0/7 and 34 6/7 weeks reduces neonatal hospital stay. STUDY DESIGN: Study subjects included 52 women between 32 0/7 and 34 6/7 weeks gestation presenting in preterm labor (regular uterine contactions R 6/hour with cervical change or dilation of R2 cm and 80% effaced) who were randomized to receive either MgSO4 tocolysis (n=28) or no tocolysis (n=24). All women received celestone 12mg IM 24 hrs apart and IV antibiotics. Tocolysis group received MgSO4 6g IV load followed by 2-5g/hr to achieve uterine quiescence followed by oral nifedepine 10-20 mg every 4-6 hrs until 36 6/7 weeks or delivery. The primary outcome was total days of neonatal hospital stay. Data were analyzed using Chi-square and T-test. RESULTS: There were no differences in maternal demographics (age, race, parity, previous preterm delivery, cervical dilation at enrollment, mean GA at enrollment, 33G0.8) and maternal outcomes (pregnancy prolongation, total hospital stay, % triage visit, % readmission). There was no difference in the primary outcome (Table), and no neonatal deaths, RDS, IVH or NEC in either group. Other neonatal outcomes are presented in the Table.