Progesterone and nifedipine for maintenance tocolysis after arrested preterm labor: A systematic review and meta-analysis of randomized controlled trial
Objective: No treatment is recommended for routine maintenance tocolysis after an arrested preterm birth. Our present study aimed to evaluate the effect of progesterone and nifedipine as maintenance tocolysis therapy after an arrested preterm birth. Materials and Methods: For relevant studies, we sy...
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doaj-3085ac85518047ed939f92b383c598b12020-11-24T23:52:30ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592016-06-0155339940410.1016/j.tjog.2015.07.005Progesterone and nifedipine for maintenance tocolysis after arrested preterm labor: A systematic review and meta-analysis of randomized controlled trialMing-Xia Ding0Xin Luo1Xue-Mei Zhang2Bing Bai3Ju-Xiang Sun4Hong-Bo Qi5Department of Obstetrics and Gynecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Obstetrics and Gynecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Obstetrics and Gynecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Obstetrics and Gynecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Obstetrics and Gynecology, Linyi People's Hospital, Linyi, ChinaDepartment of Obstetrics and Gynecology, First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaObjective: No treatment is recommended for routine maintenance tocolysis after an arrested preterm birth. Our present study aimed to evaluate the effect of progesterone and nifedipine as maintenance tocolysis therapy after an arrested preterm birth. Materials and Methods: For relevant studies, we systematically searched the literature in databases of PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library. Only randomized controlled trials were included. Results: Nine trials were included in our review. Nifedipine and progesterone were used for maintenance tocolysis. Compared to placebo treatment or no treatment, maintenance tocolysis with progesterone could significantly prolong the delivery gestational weeks [standard mean difference (SMD) 1.64; 95% confidence interval (CI), 1.21, 2.07; p < 0.00001], reduce the proportion of patients with delivery before 37 weeks (risk ratio 0.63; 95% CI, 0.47, 0.83; p = 0.001), and increase the birth weight (SMD 317.71; 95% CI, 174.89, 460.53; p < 0.0001). However, no such benefits were observed after maintenance tocolysis with nifedipine. Both nifedipine and progesterone had no significant influences on the following outcomes: neonatal intensive care unit stay, proportion of neonatal intensive care unit admission, neonatal mortality, and incidence of respiratory distress syndrome. Conclusion: Our results with maintenance tocolysis with progesterone may be useful for patients who had an episode of threatened preterm labor successfully treated with acute tocolytic therapy.http://www.sciencedirect.com/science/article/pii/S102845591600053Xmeta-analysisnifedipineprogesteronesystematic reviewtocolysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ming-Xia Ding Xin Luo Xue-Mei Zhang Bing Bai Ju-Xiang Sun Hong-Bo Qi |
spellingShingle |
Ming-Xia Ding Xin Luo Xue-Mei Zhang Bing Bai Ju-Xiang Sun Hong-Bo Qi Progesterone and nifedipine for maintenance tocolysis after arrested preterm labor: A systematic review and meta-analysis of randomized controlled trial Taiwanese Journal of Obstetrics & Gynecology meta-analysis nifedipine progesterone systematic review tocolysis |
author_facet |
Ming-Xia Ding Xin Luo Xue-Mei Zhang Bing Bai Ju-Xiang Sun Hong-Bo Qi |
author_sort |
Ming-Xia Ding |
title |
Progesterone and nifedipine for maintenance tocolysis after arrested preterm labor: A systematic review and meta-analysis of randomized controlled trial |
title_short |
Progesterone and nifedipine for maintenance tocolysis after arrested preterm labor: A systematic review and meta-analysis of randomized controlled trial |
title_full |
Progesterone and nifedipine for maintenance tocolysis after arrested preterm labor: A systematic review and meta-analysis of randomized controlled trial |
title_fullStr |
Progesterone and nifedipine for maintenance tocolysis after arrested preterm labor: A systematic review and meta-analysis of randomized controlled trial |
title_full_unstemmed |
Progesterone and nifedipine for maintenance tocolysis after arrested preterm labor: A systematic review and meta-analysis of randomized controlled trial |
title_sort |
progesterone and nifedipine for maintenance tocolysis after arrested preterm labor: a systematic review and meta-analysis of randomized controlled trial |
publisher |
Elsevier |
series |
Taiwanese Journal of Obstetrics & Gynecology |
issn |
1028-4559 |
publishDate |
2016-06-01 |
description |
Objective: No treatment is recommended for routine maintenance tocolysis after an arrested preterm birth. Our present study aimed to evaluate the effect of progesterone and nifedipine as maintenance tocolysis therapy after an arrested preterm birth.
Materials and Methods: For relevant studies, we systematically searched the literature in databases of PubMed, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library. Only randomized controlled trials were included.
Results: Nine trials were included in our review. Nifedipine and progesterone were used for maintenance tocolysis. Compared to placebo treatment or no treatment, maintenance tocolysis with progesterone could significantly prolong the delivery gestational weeks [standard mean difference (SMD) 1.64; 95% confidence interval (CI), 1.21, 2.07; p < 0.00001], reduce the proportion of patients with delivery before 37 weeks (risk ratio 0.63; 95% CI, 0.47, 0.83; p = 0.001), and increase the birth weight (SMD 317.71; 95% CI, 174.89, 460.53; p < 0.0001). However, no such benefits were observed after maintenance tocolysis with nifedipine. Both nifedipine and progesterone had no significant influences on the following outcomes: neonatal intensive care unit stay, proportion of neonatal intensive care unit admission, neonatal mortality, and incidence of respiratory distress syndrome.
Conclusion: Our results with maintenance tocolysis with progesterone may be useful for patients who had an episode of threatened preterm labor successfully treated with acute tocolytic therapy. |
topic |
meta-analysis nifedipine progesterone systematic review tocolysis |
url |
http://www.sciencedirect.com/science/article/pii/S102845591600053X |
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