Current Point of View in Preterm Labor Management in Albania

Abstract

The purpose of this study was to prevent preterm labor that uses maintenance with tocolysis therapy. This paper emphasizes the fact that there are very few hospital protocols of preterm labor that use maintenance tocolysis therapy.

Our goal is to identify the possible benefits of such therapy based on individual selection of pregnant women and their gestational age. We bring our university hospital experience study of three years with a long term use of tocolysis at risk pregnancy unit at the “Koço Gliozheni” University Hospital of Obstetrics and Gynecology, Tirana, Albania.

Qualitative method is used in this study and the prospective controlled population based study during March 2011 to March 2013 included pregnant women hospitalized for preterm labor with the criteria of: singleton pregnancy, 28-32 weeks of gestation, with no PPROM; maintenance with tocolysis therapy over one month period. Women were divided in two groups: 28-30 weeks gestation age and 30-32 weeks gestation age; tocolytics used: indomethacine, ritrodine, nifedipine, magnesium sulfate.

Data collected showed that 325 pregnant women with admission diagnosis of preterm labor which met the study criteria went under the maintenance with tocolysis therapy, 200 patients or 61.5 % with gestation age 20-30 weeks, and 125 patients or 38.5 % were 30-32 weeks of gestations. There was a significant difference in patient group of 28-30 weeks gestation age by prolonging their pregnancy more than the group of 30-32 weeks gestation age. The prolongation of pregnancy was 45 days with the use of tocolysis therapy and these patients had a major benefit compared to those that used just emergency tocolysis therapy.

The study draws to the conclusion that the use of maintenance with tocolysis therapy where there is no urgency indication for any intervention to interrupt the stay of the baby in uterus, gives considerable benefits to preterm labor diagnosed women of their singleton pregnancies and prolongs pregnancy substantially. However, use of larger population study and more studies need to be done in order to offer suitable guidelines to prevent preterm labor.

Keywords: gestation, preterm labor, prevent, tocolysis therapy