Follow-up of hydration and sedation in the pretherapy of premature labor

Intravenous fluids and sedation with 8mg of morphine sulfate intramuscularly has been used for the last 12years at our institution to define the patients in “real” premature labor. Only those who continue to have uterine contractions after this pretreatment are considered in actual premature labor. One hundred eighty-four pregnant patients with singleton pregnancies were evaluated after they were treated with hydration and sedation for the presence of regular uterine contractions. Fifty-five percent of the patients responded to hydration and sedation, and the rest required the use of tocolytic therapy. In the tocolytic therapy group, 11% gave birth to infants who were small for gestational age. The patients who responded to hydration and sedation had a 2.6-fold increase of delivering prematurely when compared to the general population. However, more than 85% of the patients who received only hydration and sedation were delivered more than 2weeks after the first episode and most of them were delivered at term. Therefore, the use of hydration and sedation seems a useful and safe clinical test to determine patients in real premature labor. Patients who respond to hydration and therapy constitute a “high-risk group” and should be managed accordingly.