Determinants of Tocolysis Failure in Preterm Labor: A Case-Control Study in Two Hospital in Yaounde

Abstract

Background: Tocolysis aims to prolong pregnancy by stopping labor to achieve lung maturation. Failure of tocolysis is a common situation in obstetrics with its share of risks and complications for the fetus.Objective: To identify the determinants of tocolysis failure in two Hospitals in Yaounde.Patients and methods: We carried out a case-control study over a 6 months period at Yaoundé Gyneco-Obstetric and Pediatric Hospital (YGOPH) and Yaounde Central Hospital (YCH). We compared each case (patient with failure of tocolysis after 48 hours) with 3 controls (patients with successful tocolysis after 48 hours). The association degree between two variables was measured by calculating the odds ratio (OR) with their confidence interval. Multivariate analysis was performed to eliminate confounders.Results: In this study,238 women were included: 62 cases and 186 controls after multivariate analysis, predictive factors were: sexual activity during the last two month of pregnancy (AOR = 2.76; CI: 1.06-7.23, p = 0,038), prenatal follow-up by midwife or nurse (AOR = 8.96 CI: 2,05-39.22, p = 0,003), the persistence of the temperature ≥ to 38°C after 48 H (AOR = 3.89; CI: 1.36-11.6, p = 0,011),) and the Bishop score ≥ 7 at admission (AOR = 12.50; CI: 4.30-36.27, p < 0,001).Conclusion: The determinants of tocolysis failure in our study were sexual activity during the last two month of pregnancy, prenatal midwife/nurse follow-up, temperature persistence ≥ 38°C after 48 hours of tocolysis, Bishop’s score ≥ 7 at admission.