Continuous long-term intravenous beta-sympathomimetic tocolysis

This report concerns the clinical course and outcome of 16 patients treated by continuous long-term intravenous beta-sympathomimetic tocolysis (greater than or equal to 1 week's intravenous therapy). Half of the patients received such therapy for at least 5 weeks. Intravenous tocolysis was adjusted to decrease uterine activity and maintain a satisfactory pulse and blood pressure. Parenteral tocolysis was continued until there was a successful transition to oral therapy, until fetal maturity, or until maternal/fetal indications for delivery were noted. Data indicate that the cardiovascular and metabolic effects were pronounced mostly during the first 3 to 4 days of therapy and then returned toward pretreatment values. In none of the study patients was the treatment discontinued because of drug-related problems, electrocardiogram changes, chorioamnionitis, or fever. The experience indicates that, in a selected group of patients and under close supervision, continuous long-term intravenous beta-sympathomimetic tocolysis may be considered a safe therapeutic modality able to prolong pregnancy with a more desirable outcome.