Is Hydration and Sedation Beneficial in the Treatment of Threatened Preterm Labor? A Preliminary Report

Hydration/sedation or hydration are currently used in the treatment of patients with preterm uterine contractions. This pilot project was undertaken to determine response rates to hydration/sedation and hedrest, hydration and bedrest, or bedrest alone in patients with preterm uterine contractions. With these response rates, power calculations and sample size were determined for a more definitive study. Patients presenting to labor and delivery with preterm uterine activity were randomized to one of three groups as follows: l) hydration/sedation and bedrest, 2) hydration and bedrest, or 3) bedrest alone. Outcome variables included cervical dilatation and contractions at entry and termination of the study, preterm delivery rates, and time to delivery. From the preliminary data it would appear that among the 116 randomized patients, no differences were seen in cervical dilatation at entry, gestational age at delivery, or interval to delivery. Furthermore, there were no differences in the need for tocolytics, nor readmission and/or retreatment for threatened preterm labor, among the three groups. It would appear that patients on bedrest alone have less of a decrease in contraction frequency than the bedrest hydration/sedation and bedrest hydration groups. In this pilot study bedrest with hydration/sedation or bedrest and hydration alone were of no more benefit than simple bedrest for treatment of patients with intact membranes and preterm uterine activity.