An Evaluation of The Success Rate and Pregnancy Outcome of Tocolysis for Preterm Contractions at Lagos University Teaching Hospital: A 5-Year Review

Abstract

Context:

Preterm contraction and resultant preterm delivery is a major contributor to perinatal morbidity and mortality. This necessitates decision to tocolyse when there is no significant cervical change, to prolong pregnancy and enhance fetal maturity. Several tocolytic agents are available and sometimes there may be a need to switch tocolytic agents when one is considered not to be as effective as expected.

Aims:

To determine prevalence of preterm contractions at Lagos University Teaching Hospital (LUTH) and the success rate of various tocolytic agents used in the last five years.

Settings and Design:  

A cross sectional study.

Methods and Material:

Data was collected from case notes of all patients managed for preterm contractions at the health facility and analyzed using SPSS version 25.0. Chi square test was used to test for association between categorical variables.

Results:

Prevalence of preterm contractions during study period was 68.1 per 1,000 obstetric admissions. Uterine inhibition was successfully achieved in 81.7% of cases following tocolysis. Tocolytic agents used during study period were oral Salbutamol, oral Nifedipine, parenteral Magnesium Sulphate and Atosiban. Atosiban was found to be most effective and Magnesium Sulphate least effective (p < 0.001). Atosiban was also found to be safest in terms of side effects compared to other tocolytic agents used (p = 0.002).

Conclusions:

The high success rate of tocolysis for preterm contractions as found in this study is encouraging. Oxytocin receptor antagonist such as Atosiban is the most the effective and safest tocolytic agent and its use needs to be encouraged where it is readily available.

Key-words: Preterm contractions, tocolysis, uterine inhibition, effectiveness, safety, side effects.

Key Messages: The use of Atosiban should be encouraged where it is readily available as it effective and safe in preterm contractions.