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Impact of a randomized trial on maintenance tocolysis on length of hospital admission of women with threatened preterm labor in The Netherlands.

Eur J Obstet Gynecol Reprod Biol. 2015 Mar;186:8-11. doi: 10.1016/j.ejogrb.2014.12.003. Epub 2014 Dec 12.

Lange TS, Roos C, Bloemenkamp KW, Bolte AC, Duvekot JJ, Franssen MT, Kok M, Oudijk MA, Porath MM, Post JA, Mol BW.
Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: delangets@gmail.com.2Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Electronic address: Carolien.Roos@radboudumc.nl.3Department of Obstetrics and Gynecology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: k.w.m.bloemenkamp@lumc.nl.4Department of Obstetrics and Gynecology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Electronic address: Annemieke.Bolte@radboudumc.nl.5Department of Obstetrics and Gynecology, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: j.j.duvekot@erasmusmc.nl.6Department of Obstetrics and Gynecology, University of Groningen, Academic Medical Center, Groningen, The Netherlands. Electronic address: m.t.m.franssen@og.umcg.nl.7Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: m.kok@amc.uva.nl.8Department of Obstetrics and Gynecology, University Medical Center, Utrecht, The Netherlands. Electronic address: m.a.oudijk-3@umcutrecht.nl.9Department of Obstetrics and Gynecology, Máxima Medical Center, Veldhoven, The Netherlands. Electronic address: m.porath@mmc.nl.10Department of Obstetrics and Gynecology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: j.a.vanderpost@amc.uva.nl.11School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide 5000, SA, Australia. Electronic address: ben.mol@adelaide.edu.au.
Eur J Obstet Gynecol Reprod Biol
ABSTRACT
AbstractINTRODUCTION: The APOSTEL-II trial was a multicenter randomized placebo-controlled trial, assessing the effectiveness of maintenance tocolysis with nifedipine. The trial showed maintenance tocolysis not to have an effect on perinatal outcome. Objective of the current study is to evaluate the effect of a negative trial on the length of hospital admission of women with threatened preterm labor.MATERIALS AND METHODS: We evaluated length of hospital admission of all patients admitted with threatened preterm labor with a gestational age <32 weeks in 8 perinatal centers that participated in the APOSTEL-II trial. We studied only the first admission with threatened preterm labor, readmissions were excluded. We distinguished between the period before, the period during and the period after the trial. In a subgroup analysis, we differentiated for the group of women who delivered and for the group of women who did not deliver during the initial admission.RESULTS: The mean length of hospital admission was 9.3 days before the start of the trial, 8.4 days during the recruitment period and 8.1 days after the trial was completed. The difference in mean length of hospital admission before and during the recruitment period was significantly different (p<001).COMMENTS: The length of hospital admission of women with threatened preterm labor is found to be reduced during the recruitment period of the APOSTEL-II trial. This shows that the conduct of a randomized controlled trial itself has the potential to change daily practice.Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Full Text Source: Elsevier Science
PMID:25596476 | http://www.ncbi.nlm.nih.gov/pubmed/25596476

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