Nifedipine versus atosiban in the treatment of threatened preterm labour (Assessment of Perinatal Outcome after Specific Tocolysis in Early Labour: APOSTEL III-Trial)

Elvira O. G. van Vliet; Ewoud Schuit; Karst Y. Heida; Brent C. Opmeer; Marjolein Kok; Wilfried Gyselaers; Martina M. Porath; Mallory Woiski; Caroline J. Bax; Kitty W. M. Bloemenkamp; Hubertina C. J. Scheepers; Yves Jaquemyn; Erik van Beek; Hans J. J. Duvekot; Maureen T. M. Franssen; Bas N. Bijvank; Joke H. Kok; Arie Franx; Ben Willem J. Mol; Martijn A. Oudijk

doi:10.1186/1471-2393-14-93

Nifedipine versus atosiban in the treatment of threatened preterm labour (Assessment of Perinatal Outcome after Specific Tocolysis in Early Labour: APOSTEL III-Trial)

Elvira O. G. van Vliet^*, Ewoud Schuit, Karst Y. Heida, Brent C. Opmeer, Marjolein Kok, Wilfried Gyselaers, Martina M. Porath, Mallory Woiski, Caroline J. Bax, Kitty W. M. Bloemenkamp, Hubertina C. J. Scheepers, Yves Jaquemyn, Erik van Beek, Hans J. J. Duvekot, Maureen T. M. Franssen, Bas N. Bijvank, Joke H. Kok, Arie Franx, Ben Willem J. Mol, Martijn A. Oudijk

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Background: Preterm birth is the most common cause of neonatal morbidity and mortality. Postponing delivery for 48 hours with tocolytics to allow for maternal steroid administration and antenatal transportation to a centre with neonatal intensive care unit facilities is the standard treatment for women with threatening preterm delivery in most centres. However, there is controversy as to which tocolytic agent is the drug of first choice. Previous trials have focused on tocolytic efficacy and side effects, and are probably underpowered to detect clinically meaningfull differences in neonatal outcome. Thus, the current evidence is inconclusive to support a balanced recommendation for clinical practice. This multicenter randomised clinical trial aims to compare nifedipine and atosiban in terms of neonatal outcome, duration of pregnancy and maternal side effects.

Methods/Design: The Apostel III trial is a nationwide multicenter randomised controlled study. Women with threatened preterm labour (gestational age 25-34 weeks) defined as at least 3 contractions per 30 minutes, and 1) a cervical length of

Discussion: This trial will provide evidence on the optimal drug of choice in acute tocolysis in threatening preterm labour.

Original language	English
Article number	93
Number of pages	6
Journal	BMC Pregnancy and Childbirth
Volume	14
DOIs	https://doi.org/10.1186/1471-2393-14-93
Publication status	Published - 3-Mar-2014

Keywords

Preterm birth
Tocolytics
Nifedipine
Atosiban
Outcome
Drug safety
BIRTH
DELIVERY
EPIDEMIOLOGY
METAANALYSIS
THERAPY

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van Vliet, E. O. G., Schuit, E., Heida, K. Y., Opmeer, B. C., Kok, M., Gyselaers, W., Porath, M. M., Woiski, M., Bax, C. J., Bloemenkamp, K. W. M., Scheepers, H. C. J., Jaquemyn, Y., van Beek, E., Duvekot, H. J. J., Franssen, M. T. M., Bijvank, B. N., Kok, J. H., Franx, A., Mol, B. W. J., & Oudijk, M. A. (2014). Nifedipine versus atosiban in the treatment of threatened preterm labour (Assessment of Perinatal Outcome after Specific Tocolysis in Early Labour: APOSTEL III-Trial). BMC Pregnancy and Childbirth, 14, [93]. https://doi.org/10.1186/1471-2393-14-93

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title = "Nifedipine versus atosiban in the treatment of threatened preterm labour (Assessment of Perinatal Outcome after Specific Tocolysis in Early Labour: APOSTEL III-Trial)",

abstract = "Background: Preterm birth is the most common cause of neonatal morbidity and mortality. Postponing delivery for 48 hours with tocolytics to allow for maternal steroid administration and antenatal transportation to a centre with neonatal intensive care unit facilities is the standard treatment for women with threatening preterm delivery in most centres. However, there is controversy as to which tocolytic agent is the drug of first choice. Previous trials have focused on tocolytic efficacy and side effects, and are probably underpowered to detect clinically meaningfull differences in neonatal outcome. Thus, the current evidence is inconclusive to support a balanced recommendation for clinical practice. This multicenter randomised clinical trial aims to compare nifedipine and atosiban in terms of neonatal outcome, duration of pregnancy and maternal side effects.Methods/Design: The Apostel III trial is a nationwide multicenter randomised controlled study. Women with threatened preterm labour (gestational age 25-34 weeks) defined as at least 3 contractions per 30 minutes, and 1) a cervical length ofDiscussion: This trial will provide evidence on the optimal drug of choice in acute tocolysis in threatening preterm labour.",

keywords = "Preterm birth, Tocolytics, Nifedipine, Atosiban, Outcome, Drug safety, BIRTH, DELIVERY, EPIDEMIOLOGY, METAANALYSIS, THERAPY",

author = "{van Vliet}, {Elvira O. G.} and Ewoud Schuit and Heida, {Karst Y.} and Opmeer, {Brent C.} and Marjolein Kok and Wilfried Gyselaers and Porath, {Martina M.} and Mallory Woiski and Bax, {Caroline J.} and Bloemenkamp, {Kitty W. M.} and Scheepers, {Hubertina C. J.} and Yves Jaquemyn and {van Beek}, Erik and Duvekot, {Hans J. J.} and Franssen, {Maureen T. M.} and Bijvank, {Bas N.} and Kok, {Joke H.} and Arie Franx and Mol, {Ben Willem J.} and Oudijk, {Martijn A.}",

year = "2014",

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day = "3",

doi = "10.1186/1471-2393-14-93",

language = "English",

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van Vliet, EOG, Schuit, E, Heida, KY, Opmeer, BC, Kok, M, Gyselaers, W, Porath, MM, Woiski, M, Bax, CJ, Bloemenkamp, KWM, Scheepers, HCJ, Jaquemyn, Y, van Beek, E, Duvekot, HJJ, Franssen, MTM, Bijvank, BN, Kok, JH, Franx, A, Mol, BWJ & Oudijk, MA 2014, 'Nifedipine versus atosiban in the treatment of threatened preterm labour (Assessment of Perinatal Outcome after Specific Tocolysis in Early Labour: APOSTEL III-Trial)', BMC Pregnancy and Childbirth, vol. 14, 93. https://doi.org/10.1186/1471-2393-14-93

Nifedipine versus atosiban in the treatment of threatened preterm labour (Assessment of Perinatal Outcome after Specific Tocolysis in Early Labour : APOSTEL III-Trial). / van Vliet, Elvira O. G.; Schuit, Ewoud; Heida, Karst Y. et al.

In: BMC Pregnancy and Childbirth, Vol. 14, 93, 03.03.2014.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Nifedipine versus atosiban in the treatment of threatened preterm labour (Assessment of Perinatal Outcome after Specific Tocolysis in Early Labour

T2 - APOSTEL III-Trial)

AU - van Vliet, Elvira O. G.

AU - Schuit, Ewoud

AU - Heida, Karst Y.

AU - Opmeer, Brent C.

AU - Kok, Marjolein

AU - Gyselaers, Wilfried

AU - Porath, Martina M.

AU - Woiski, Mallory

AU - Bax, Caroline J.

AU - Bloemenkamp, Kitty W. M.

AU - Scheepers, Hubertina C. J.

AU - Jaquemyn, Yves

AU - van Beek, Erik

AU - Duvekot, Hans J. J.

AU - Franssen, Maureen T. M.

AU - Bijvank, Bas N.

AU - Kok, Joke H.

AU - Franx, Arie

AU - Mol, Ben Willem J.

AU - Oudijk, Martijn A.

PY - 2014/3/3

Y1 - 2014/3/3

N2 - Background: Preterm birth is the most common cause of neonatal morbidity and mortality. Postponing delivery for 48 hours with tocolytics to allow for maternal steroid administration and antenatal transportation to a centre with neonatal intensive care unit facilities is the standard treatment for women with threatening preterm delivery in most centres. However, there is controversy as to which tocolytic agent is the drug of first choice. Previous trials have focused on tocolytic efficacy and side effects, and are probably underpowered to detect clinically meaningfull differences in neonatal outcome. Thus, the current evidence is inconclusive to support a balanced recommendation for clinical practice. This multicenter randomised clinical trial aims to compare nifedipine and atosiban in terms of neonatal outcome, duration of pregnancy and maternal side effects.Methods/Design: The Apostel III trial is a nationwide multicenter randomised controlled study. Women with threatened preterm labour (gestational age 25-34 weeks) defined as at least 3 contractions per 30 minutes, and 1) a cervical length ofDiscussion: This trial will provide evidence on the optimal drug of choice in acute tocolysis in threatening preterm labour.

AB - Background: Preterm birth is the most common cause of neonatal morbidity and mortality. Postponing delivery for 48 hours with tocolytics to allow for maternal steroid administration and antenatal transportation to a centre with neonatal intensive care unit facilities is the standard treatment for women with threatening preterm delivery in most centres. However, there is controversy as to which tocolytic agent is the drug of first choice. Previous trials have focused on tocolytic efficacy and side effects, and are probably underpowered to detect clinically meaningfull differences in neonatal outcome. Thus, the current evidence is inconclusive to support a balanced recommendation for clinical practice. This multicenter randomised clinical trial aims to compare nifedipine and atosiban in terms of neonatal outcome, duration of pregnancy and maternal side effects.Methods/Design: The Apostel III trial is a nationwide multicenter randomised controlled study. Women with threatened preterm labour (gestational age 25-34 weeks) defined as at least 3 contractions per 30 minutes, and 1) a cervical length ofDiscussion: This trial will provide evidence on the optimal drug of choice in acute tocolysis in threatening preterm labour.

KW - Preterm birth

KW - Tocolytics

KW - Nifedipine

KW - Atosiban

KW - Outcome

KW - Drug safety

KW - BIRTH

KW - DELIVERY

KW - EPIDEMIOLOGY

KW - METAANALYSIS

KW - THERAPY

U2 - 10.1186/1471-2393-14-93

DO - 10.1186/1471-2393-14-93

M3 - Article

SN - 1471-2393

VL - 14

JO - BMC Pregnancy and Childbirth

JF - BMC Pregnancy and Childbirth

M1 - 93

ER -