P01.06: Effectiveness of the contemporary treatment of preterm labour: a comparison with a historical cohort

Abstract

To compare the effectiveness of contemporary treatment of preterm labour to a historical cohort. Retrospective matched case-control study to compare the outcomes of patients that were treated for preterm labour at the University Hospital of Tuebingen, Germany in 2014/ 2015 (current treatment cohort) and 2006/2007 (historical cohort). The study included women with singleton gestations who were admitted with the diagnosis of preterm labour between 24+0 and 34+0 weeks' gestation and a cervical length of ≤15 mm. Women in the historical cohort were hospitalised until either 34 weeks' gestation or until complete cessation of uterine contractions. They were treated with intravenous beta-mimetics continuously, received antibiotics based on the vaginal culture and corticosteroids regardless of cervical length measurement. Bed rest was always recommended. The current treatment cohort was tocolysed with an oral calcium channel blocker for approximately 3 days followed by vaginal progesterone until 34 weeks' gestation. Corticosteroids were given only if the cervical length is ≤15 mm. Bed rest was not recommended. The study population consisted of 110 pregnancies, 55 in the historical cohort and 55 in the current treatment cohort. At the time of admission, mean gestational age in both groups was 29.3 and 29.7 weeks. In the historical and current treatment cohort the length of the hospitalisation was 24.0 and 5.5 days and tocolysis was given for 19.5 and 3.4 days, respectively. In the historical cohort, mean gestational age at delivery was 35.6 weeks. In 63.6% cases delivery occurred prior to 37 weeks. In the current treatment group mean gestational age at the delivery was 37.0 weeks and 36.4% were delivered prior to 37 weeks. Short-term hospitalisation and tocolysis followed by vaginal progesterone for maintenance tocolysis is more effective than a protocol which includes long term hospital stay, beta-mimetics, antibiotics, and bed rest.