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261: Tocolytic therapy in preterm premature rupture of membranes

      Objective

      To determine if tocolytic administration will extend the latency period from preterm premature rupture of membranes (PPROM) to delivery.

      Study Design

      Prospective, randomized, controlled trial

      Results

      Sixty-nine patients were enrolled and randomized to the three study groups: 22 patient in Group A (tocolysis with MgSO4 until delivery), 26 patients in Group B (tocolysis with MgSO4 for 48 hours only), and 21 patients in Group C (no tocolysis). All three groups were similar in regard to age, race, and estimated gestational age at the time of enrollment. The latency period was found to be significantly different between the treatment groups, with 16.1 days in Group A, 14.4 days in Group B, and 7.2 days in Group C (p = 0.002). However, despite a significant difference in latency between the groups, there were no significant differences in maternal endometritis (p = 0.931) or neonatal outcomes (RDS: p = 0.989, days on the ventilator: p = 0.763, IVH: p = 0.235, sepsis: p = 0.476, NICU days: p = 0.747).

      Conclusion

      The utilization of MgSO4 tocolysis in patients with preterm premature rupture of membranes increases the latency period between rupture of membranes and delivery. In this study, MgSO4 for the 48 hours after admission during which antenatal corticosteroids were administered doubled the latency period when compared to the group receiving no tocolytics (14.4 days and 7.2 days, respectively), and prolonged usage of MgSO4 prolonged latency further. However, despite the significant difference in prolongation of latency, maternal and neonatal outcomes were not shown to be significantly different. A larger study may be necessary to demonstrate significant differences in these other outcomes.