Aim: To determine current attitudes and practices regarding the suppression of preterm labour among obstetricians in Australia and New Zealand.
Methods: A questionnaire mailed to all Diplomates, Members and Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists in April 2002.
Results: A total of 813 surveys were returned - 33% (470/1412) of Fellows and Members and 11% (322/2806) of Diplomates. The response rate for Australia was 18.9% (759 of 4019) compared to 27.1% (54 of 199) from New Zealand. Routine suppression of preterm labour was attempted by 79% of respondents, primarily to prolong pregnancy for steroid administration (83%) and/or transfer (74%). The gestation for initiation of suppression ranged from 20 to 37 weeks. Tocolysis was discontinued at 32.9 +/- 2.7 weeks (mean +/- SD), range 24-38 weeks. The first choice drug for tocolysis was the beta-adrenergic group (73%), followed by nifedipine (21%). Maintenance tocolysis was used by 34%. Respondents were asked the percentage of women in whom suppression was attempted that achieved: (i) steroid cover--median 80% (range 10-100); (ii) prolongation of pregnancy > or =7 days--50% (0-100); and (iii) prolongation of pregnancy to term--10% (0-100).
Conclusion: Most respondents attempted to suppress preterm labour for steroid administration and/or transfer. However, a wide range of opinions and uncertainty was evident as to the effectiveness of tocolytic therapy in clinical management, the most appropriate drug and drug side-effects.