Prolongation of pregnancy in multiple pregnancy

Abstract

Objective: The purpose of the study was to determine whether the use of prophylactic oral ritodrine or hospitalization for bed rest can prolong pregnancy in multiple pregnancy.

Methods: The study was conducted over a period of 8 years and included 189 cases of multiple pregnancy, all of which were delivered at the King Fahd Hospital of the University, Al-Khobar, Saudi Arabia, between July 1986 and August 1994. The patients were divided into three groups: the first group included 64 patients who received oral ritodrine from the 25th to the end of the 37th week of gestation; the second group included 57 patients who were hospitalized from the 28th to the 32nd week of gestation; and the third group, considered the control group, included 68 patients who were managed on an outpatient basis only. Forty-six cases of multiple pregnancy were excluded from the study for a variety of reasons.

Results: The study showed an increase in gestational age at delivery, an increase in mean birth weight and a reduction in preterm delivery in the group treated with prophylactic ritodrine (P = 0.03). In the hospitalized group there was no effect on duration of gestation or reduction in preterm delivery, but there was an increase in mean birth weight (P = 0.04). Several patients experienced troublesome side effects with ritodrine.

Conclusion: Our study indicates that the prophylactic use of beta-sympathomimetics is more effective, beneficial and less expensive than hospitalization for bed rest in prevention of preterm labor and delivery in multiple pregnancy.