Differences between evidence-based recommendations and actual clinical practice regarding tocolysis: a prospective multicenter registry study
Abstract Background International guidelines recommend that tocolytic therapy be restricted to a single 48-h application. However, multiple cycles of tocolytic therapy and maintenance therapy that exceeds 48 h appear to play a role in daily clinical practice. We aimed to evaluate current trends in c...
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doaj-8ba2c32c13054a0890fca557791c345a2020-11-25T02:17:19ZengBMCBMC Pregnancy and Childbirth1471-23932018-11-011811810.1186/s12884-018-2078-5Differences between evidence-based recommendations and actual clinical practice regarding tocolysis: a prospective multicenter registry studyEmina Nazifovic0Heinrich Husslein1Ioana Lakovschek2Florian Heinzl3Elisabeth Wenzel-Schwarz4Philipp Klaritsch5Ekrem Kilic6Sarah Hoesel7Rudolf Bind8Magdalena Pabinger9Harald Zeisler10Lorenz Kuessel11Department of Gynecology and Obstetrics, Semmelweis FrauenklinikDepartment of Gynecology and Obstetrics, Medical University of ViennaDepartment of Obstetrics and Gynecology, Medical University of GrazDepartment of Gynecology and Obstetrics, Medical University of ViennaDepartment of Gynecology and Obstetrics, St. Josef KrankenhausDepartment of Obstetrics and Gynecology, Medical University of GrazDepartment of Gynecology and Obstetrics, Medical University of Krems, University Hospital of TullnDepartment of Gynecology and Obstetrics, Klinikum Klagenfurt am WörtherseeDepartment of Gynecology and Obstetrics, Landesklinikum ZwettlDepartment of Gynecology and Obstetrics, Krankenanstalt RudolfstiftungDepartment of Gynecology and Obstetrics, Medical University of ViennaDepartment of Gynecology and Obstetrics, Medical University of ViennaAbstract Background International guidelines recommend that tocolytic therapy be restricted to a single 48-h application. However, multiple cycles of tocolytic therapy and maintenance therapy that exceeds 48 h appear to play a role in daily clinical practice. We aimed to evaluate current trends in clinical practice with respect to treatment with tocolytic agents and to identify differences between evidence-based recommendations and daily clinical practice in Austria. Methods A prospective multicenter registry study was conducted from October 2013 through April 2015 in ten obstetrical departments in Austria. Women ≥18 years of age who received tocolytic therapy following a diagnosis of threatened preterm birth were included, and details were obtained regarding clinical characteristics, tocolytic therapy, and pregnancy outcome. Results A total of 309 women were included. We observed a median of 2 cycles of tocolytic therapy per patient (IQR 1–3) with a median duration of 2 days per cycle (IQR 2–5). Repeat tocolysis was administered in 41.7% of women, resulting in up to six tocolysis cycles; moreover, 40.8% of the first tocolysis cycles were maintenance tocolysis (i.e., longer than 48 h). Only 25.6% of women received one single 48-h tocolysis cycle in which they received antenatal corticosteroids for fetal lung maturation in accordance evidence-based recommendations. Conclusions Here, we report a clear disparity between evidence-based recommendations and daily practice with respect to tocolysis. We believe that the general practice of prescribing tocolytic therapy must be revisited. Furthermore, our findings highlight the need for contemporary studies designed to investigate the effectiveness of performing maintenance and/or repetitive tocolysis treatment.http://link.springer.com/article/10.1186/s12884-018-2078-5 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Emina Nazifovic Heinrich Husslein Ioana Lakovschek Florian Heinzl Elisabeth Wenzel-Schwarz Philipp Klaritsch Ekrem Kilic Sarah Hoesel Rudolf Bind Magdalena Pabinger Harald Zeisler Lorenz Kuessel |
spellingShingle |
Emina Nazifovic Heinrich Husslein Ioana Lakovschek Florian Heinzl Elisabeth Wenzel-Schwarz Philipp Klaritsch Ekrem Kilic Sarah Hoesel Rudolf Bind Magdalena Pabinger Harald Zeisler Lorenz Kuessel Differences between evidence-based recommendations and actual clinical practice regarding tocolysis: a prospective multicenter registry study BMC Pregnancy and Childbirth |
author_facet |
Emina Nazifovic Heinrich Husslein Ioana Lakovschek Florian Heinzl Elisabeth Wenzel-Schwarz Philipp Klaritsch Ekrem Kilic Sarah Hoesel Rudolf Bind Magdalena Pabinger Harald Zeisler Lorenz Kuessel |
author_sort |
Emina Nazifovic |
title |
Differences between evidence-based recommendations and actual clinical practice regarding tocolysis: a prospective multicenter registry study |
title_short |
Differences between evidence-based recommendations and actual clinical practice regarding tocolysis: a prospective multicenter registry study |
title_full |
Differences between evidence-based recommendations and actual clinical practice regarding tocolysis: a prospective multicenter registry study |
title_fullStr |
Differences between evidence-based recommendations and actual clinical practice regarding tocolysis: a prospective multicenter registry study |
title_full_unstemmed |
Differences between evidence-based recommendations and actual clinical practice regarding tocolysis: a prospective multicenter registry study |
title_sort |
differences between evidence-based recommendations and actual clinical practice regarding tocolysis: a prospective multicenter registry study |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2018-11-01 |
description |
Abstract Background International guidelines recommend that tocolytic therapy be restricted to a single 48-h application. However, multiple cycles of tocolytic therapy and maintenance therapy that exceeds 48 h appear to play a role in daily clinical practice. We aimed to evaluate current trends in clinical practice with respect to treatment with tocolytic agents and to identify differences between evidence-based recommendations and daily clinical practice in Austria. Methods A prospective multicenter registry study was conducted from October 2013 through April 2015 in ten obstetrical departments in Austria. Women ≥18 years of age who received tocolytic therapy following a diagnosis of threatened preterm birth were included, and details were obtained regarding clinical characteristics, tocolytic therapy, and pregnancy outcome. Results A total of 309 women were included. We observed a median of 2 cycles of tocolytic therapy per patient (IQR 1–3) with a median duration of 2 days per cycle (IQR 2–5). Repeat tocolysis was administered in 41.7% of women, resulting in up to six tocolysis cycles; moreover, 40.8% of the first tocolysis cycles were maintenance tocolysis (i.e., longer than 48 h). Only 25.6% of women received one single 48-h tocolysis cycle in which they received antenatal corticosteroids for fetal lung maturation in accordance evidence-based recommendations. Conclusions Here, we report a clear disparity between evidence-based recommendations and daily practice with respect to tocolysis. We believe that the general practice of prescribing tocolytic therapy must be revisited. Furthermore, our findings highlight the need for contemporary studies designed to investigate the effectiveness of performing maintenance and/or repetitive tocolysis treatment. |
url |
http://link.springer.com/article/10.1186/s12884-018-2078-5 |
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