Tocolytic therapy in conservative management of symptomatic placenta previa

Abstract 

Objectives: To study the effect of ritodrine therapy on maternal and perinatal outcome in cases of symptomatic placenta previa being managed conservatively. Methods: A prospective, randomized controlled clinical trial was made of a total of 60 women whose pregnancies ranged from 28 through 34 menstrual weeks who were randomly allocated to the two study groups using Tippet's random number table. Of these women, 30 were included in the study group where tocolysis with ritodrine was given whereas the other 30 in the control group did not receive tocolysis. Prolongation of pregnancy and birth weight of the newborn were evaluated. The unpaired t-test and chi-square test were used for statistical analysis. Results: Use of tocolysis in symptomatic placenta previa was associated with significant prolongation of pregnancy (25.33 vs. 14.47 days, P<0.05) and difference in birth weight (2270 g vs. 1950 g, P<0.05). There was no observed statistical difference between the two groups with regard to number of episodes of hemorrhage after admission, total amount of blood loss during stay in hospital, number of blood transfusions and maternal complications due to tocolysis in the study group. Conclusions: The present prospective study suggests that ritodrine hydrochloride in patients with symptomatic placenta previa tends to prolong the pregnancy and result in an increase in birth weight of the babies without causing any adverse effect on the mother and fetus.

Keywords: Tocolysis, Placenta previa