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Keywords:

  • management;
  • preterm labour;
  • survey;
  • tocolytics

Abstract

Aim:  To determine current attitudes and practices regarding the suppression of preterm labour among obstetricians in Australia and New Zealand.

Methods:  A questionnaire mailed to all Diplomates, Members and Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists in April 2002.

Results:  A total of 813 surveys were returned – 33% (470/1412) of Fellows and Members and 11% (322/2806) of Diplomates. The response rate for Australia was 18.9% (759 of 4019) compared to 27.1% (54 of 199) from New Zealand. Routine suppression of preterm labour was attempted by 79% of respondents, primarily to prolong pregnancy for steroid administration (83%) and/or transfer (74%). The gestation for initiation of suppression ranged from 20 to 37 weeks. Tocolysis was discontinued at 32.9 ± 2.7 weeks (mean ± SD), range 24–38 weeks. The first choice drug for tocolysis was the β-adrenergic group (73%), followed by nifedipine (21%). Maintenance tocolysis was used by 34%. Respondents were asked the percentage of women in whom suppression was attempted that achieved: (i) steroid cover – median 80% (range 10–100); (ii) prolongation of pregnancy ≥7 days – 50% (0–100); and (iii) prolongation of pregnancy to term – 10% (0–100).

Conclusion:  Most respondents attempted to suppress preterm labour for steroid administration and/or transfer. However, a wide range of opinions and uncertainty was evident as to the effectiveness of tocolytic therapy in clinical management, the most appropriate drug and drug side-effects.