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Table 1 Characteristics of randomized trials comparing initial tocolysis vs. no tocolysis or placebo in women with PPROM

From: Tocolysis in the management of preterm prelabor rupture of membranes at 22–33 weeks of gestation: study protocol for a multicenter, double-blind, randomized controlled trial comparing nifedipine with placebo (TOCOPROM)

Author, year (reference)

Methods, n

Inclusion criteria

Intervention

Antibiotics / Steroids

Primary outcome

Main result

Christensen, 1980 [29]

RCT, n = 30

Singletons, 28–36 wks, with contractions

Ritodrine vs placebo, until 35 wks

Only for urogenital colonization / not specified

Not pre-specified

Significant reduction of deliveries within 24 h, no difference at 48 h

Levy, 1985 [30]

RCT, n = 42

Singletons, 25–34 wks, no contractions

Ritodrine vs placebo, until labor

Only if cesarean section / no

Latency period

Significant prolonged mean latency period for treated women

Dunlop, 1986 [31]

RCT, n = 48

Singletons, 26–34 wks, no uterine contractions

A: no ritodrine, no cephalexin

B: ritodrine, cephalexin

C: ritodrine, no cephalexin

D: no ritodrine, cephalexin

Only for groups B and D / systematic

Type of labor, mode of delivery, neonatal and maternal outcomes including admission to birth interval

No advantage to the newborn

Garite, 1987 [32]

RCT, n = 79

Singletons, 25–30 wks, with or without contractions

Ritodrine vs placebo, until 31 wks

Only if cesarean section / no

Time interval from PPROM to birth

No difference

Weiner, 1988 [33]

RT, n = 75 (+ 34 excluded from analyses)

Singletons, up to 34 wks, with contractions

Ritodrine, terbutaline or magnesium sulfate vs bedrest, no clear duration

Only for urogenital colonization / no

Not clearly stated

No difference

Matsuda, 1993 [34]

RT, n = 81

Singletons, 23–34 wks, no contractions

Ritodrine vs bedrest, no clear duration

Only for treated women / not specified

Prolongation of pregnancy

Prolongation for more than 72 h was greater for treated women

How, 1998 [35]

RCT, n = 145

Singletons and twins, 24–34 wks, not in labor

Magnesium sulfate (treatment initiated only if contractions occurred) vs no tocolysis

Systematic / systematic (weekly)

Not clearly stated

No difference in latency duration, no difference in neonatal outcomes

Ehsanipoor, 2011 [36]

RCT, n = 47

Singletons, 24–31 w, no contractions

Indomethacin vs placebo, for 48 h

Systematic / systematic

Delivery within 48 h

No difference

Nijman, 2016 [37]

RCT, n = 50

Singletons and twins, 24–33 wks, no contractions

Nifedipine vs placebo, until the onset of labor (up to 18 days or 34 wks)

According to local guidelines / Systematic

Composite of poor neonatal outcome

No difference

  1. h hours, RCT randomized controlled trial, RT randomized trial, wks weeks