PROLONGED INTRAVENOUS RITODRINE THERAPY - A COMPARISON BETWEEN MULTIPLE AND SINGLETON PREGNANCIES

To compare multiple and singleton pregnancies in the treatment of thre atened preterm delivery with prolonged intravenous ritodrine, 32 women with multiple pregnancy (26 twins, 6 triplets, 70 fetuses, 30.3 +/- 3 .5 weeks) and 51 women with singleton pregnancy (31.3 +/- 2.6 weeks) a dmitted for threatened preterm delivery without rupture of the membran es were the subjects of a retrospective study of obstetric data, perin atal outcome and maternal adverse effects. Significance was assessed b y chi(2) test and Student's t test. Multiple pregnancies were associat ed with a marked increase in the duration of tocolysis (17.2 +/- 17.3 vs. 7.6 +/- 8.1 days, P < 0.01), incidence of delivery before 37 weeks (87.5 vs. 35.3%, P < 0.01) and incidence of maternal cardiovascular c omplications (34.4 vs. 4.0%, P < 0.01), including three cases of pulmo nary edema. The incidences of delivery before 32 weeks (12.5 vs. 7.8%) and of neonatal death (2.9 vs. 0%) were not significantly different i n the two groups. Multiple pregnancies dramatically increased the inci dence of maternal adverse effects of prolonged intravenous ritodrine t herapy. Neonatal benefit is questionable and was difficult to establis h since it was not a randomized study.