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This study was undertaken to assess t he effectiveness of glyceryl trinitrate(GTN)patches in comparison withβ2sympathomimetics(β2)for the treatment of preterm labor.A multicenter,multinational,randomized controlled trial-was conducted in tertiary referral t eaching hospitals.Women in threatened preterm labor wi th positive fetal fi-bronectin or ruptured membranes between 24and 35weeks’gestation were recruited and random ly assigned to eitherβ2or GTN with rescueβ2tocolysis if moderate -to -strong contractions persisted a t 2hours.Obstetric and neonatal outcomes were assessed.Tw o hundred thity -eight women were recruited and randomly assigned,117toβ2and 121to GTN.On a strict intention-to -treat ba-sis,there was no significant difference in the time to de-livery using Kaplan -Meier curves(P =.451).At 2hours,27%of women receivingβ2had moderate or stronger contractions compared wit h 53%in the GTN group(P<.001).This led to 35%of women in the GTN group receiving rescue treatment.I f delivery or require-ment forβ2rescue are regarded as treatment fa ilure,then a significant differencewas ob served between the 2arms (P =.0032).There were no significant differen ces in neonatal outcomes.GTN is a less efficacious tocolytic compared with fl2sympathomimetics.
This study was undertaken to assess the effectiveness of glyceryl trinitrate (GTN) patches in comparison with β2 sympathomimetics (β2) for the treatment of preterm labor. A multicenter, multinational, randomized controlled trial-was conducted in tertiary referral t eaching hospitals. preterm labor wi th positive fetal fi-bronectin or ruptured membranes between 24 and 35weeks’gestation were recruited and random ly assigned to eitherβ2or GTN with rescueβ2tocolysis if moderate-to-str contra contrapdated 2hours.Obstetric and neonatal outcomes were assessed.Thousand hundred thity -eight women were recruited and randomly assigned, 117toβ2and 121to GTN.On a strict intention-to-treat ba-sis, there was no significant difference in the time to de livery using Kaplan-Meier curves (P = .451) .At 2 hours, 27% of women receiving β2had moderate or stronger contractions than wit h 53% in the GTN group (P <.001). This led to 35% of women in the GTN group receiving rescue treatment. I fd elivery or require-ment for β2rescue are considered as treatment fa ilure, then a significant differencewas ob ob served between 2arms (p = .0032). There were no significant differences in neonatal outcomes.GTN is a less efficacious tocolytic compared with fl2sympathomimetics.