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Effectiveness of the contemporary treatment of preterm labor: a comparison with a historical cohort

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To compare the effectiveness of contemporary treatment of preterm labor to a historical cohort.

Study design

Retrospective matched case–control study to compare the outcomes of patients that were treated for preterm labor 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 labor between 24 + 0 and 34 + 0 weeks’ gestation and a cervical length of ≤15 mm. Women in the historical cohort were hospitalized 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 tocolyzed 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.

Results

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 hospitalization 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.

Conclusion

Short-term hospitalization 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.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, University of Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany

    Philipp Wagner, Harald Abele, Loefler Sarah, Markus Hoopmann, Sara Brucker & Karl Oliver Kagan

  2. Fetal Medicine Foundation USA, Dayton, OH, USA

    Jiri Sonek

  3. Division of Maternal Fetal Medicine, Wright State University, Dayton, OH, USA

    Jiri Sonek

  4. Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China

    Qinging Wu

Authors
  1. Philipp Wagner
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  2. Jiri Sonek
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  3. Harald Abele
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  4. Loefler Sarah
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  5. Markus Hoopmann
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  6. Sara Brucker
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  7. Qinging Wu
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  8. Karl Oliver Kagan
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Contributions

PW: data collection and analysis. JS: manuscript writing and editing. HA: manuscript writing and editing. LS: data collection. MH: manuscript writing and editing. SB: manuscript writing and editing. QW: manuscript writing and editing. KOK: project development, data analysis, manuscript writing and editing

Corresponding author

Correspondence to Karl Oliver Kagan.

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Conflict of interest

All authors declare that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This is a retrospective study from patients that were treated at the University of Tuebingen, Germany. The study was approved by the local ethical committee. This is also stated in the Methods section.

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Wagner, P., Sonek, J., Abele, H. et al. Effectiveness of the contemporary treatment of preterm labor: a comparison with a historical cohort. Arch Gynecol Obstet 296, 27–34 (2017). https://doi.org/10.1007/s00404-017-4389-6

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  • DOI: https://doi.org/10.1007/s00404-017-4389-6

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