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Re: Tocolysis.From: dahmd@gate.netSat Oct 21 12:03:23 1995
>absent from this discussion is evidence that oral therapy has been shown to >be efficacious in any randomized study. additionally, there is no evidence >of efficacy for tocolytic therapy in general, save for forestalling >delivery for a short interval. why, then, are we using these drugs and whom >are we treating? these issues urgently need addressing.how about some >trials using fibronectin in the triaging of patients for therapy? so far, >it appears that an antibiotic may make the best tocolytic. > >art fougner I think I'm the only OB in my hospital that does not use oral terbutaline after discharge. I don't think there is any evidence that oral tocolytics help at all, and since PO terbutaline has some nasty side-effects, I don't use it. Everyone seems to have a good anecdote, however, along the lines of "Well, I had a lady once who was stopped on PO terbutaline and went on to deliver postdates". Of course, this is hardly scientific. I suspect that we're all uncomfortable with any preterm contractions or uterine irritability, and because we feel the need to "try something", we end up tocolysing ourselves, and not really doing much for the patient. D. Ashley Hill, M.D. dahmd@gate.net Orlando, Florida
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