Duration of Pregnancy Prolongation with Atosiban in Twin Pregnancies Diagnosed with Threatened Preterm Labor

Abstract

Background: Twin pregnancy is a high-risk condition associated with numerous maternal and fetal complications. Common complications include hypertensive disorders, preterm birth, congenital abnormalities, and those specific to twin gestations. Among these, preterm birth is the most prevalent, with a rate exceeding 50% in twin pregnancies, 10.8 times higher than in singleton pregnancies. Preterm birth not only leads to significant neonatal morbidity and mortality but also imposes a substantial economic burden for neonatal care. Approximately 70% of preterm infant deaths occur in the neonatal period, and 50% of these children die within the first five years of life. The cornerstone of managing threatened preterm labor focuses on preventing or inhibiting uterine contractions, thereby prolonging pregnancy to allow for the administration of corticosteroids for fetal lung maturation, magnesium sulfate for fetal neuroprotection, and transfer to a tertiary care center. Atosiban is a highly effective tocolytic agent with minimal maternal and fetal side effects.

Methods: This was a retrospective case series study of 81 pregnant women with twin gestations diagnosed with threatened preterm labor, who were treated with Atosiban at Tu Du Hospital.

Results: The mean pregnancy prolongation was 120 hours. The rate of pregnancy prolongation for ≥ 48 hours was 88.9%. The incidence of adverse effects from Atosiban was low (2.5%).

Conclusion: Atosiban is a highly effective and well-tolerated tocolytic agent for the management of threatened preterm labor in women with twin pregnancies.

Keywords: Preterm birth, twin pregnancy, tocolysis, Atosiban