Efficacy of aggressive tocolysis for preterm labor with advanced cervical dilatation

OBJECTIVE: Study the effectiveness of tocolysis for preterm labor with advanced cervical dilatation ( > or = 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 > or = 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.