SynthesisSystematic reviews2018
Using tocolysis in pregnant women with symptomatic placenta praevia does not significantly improve prenatal, perinatal, neonatal and maternal outcomes: a systematic review and meta-analysis.
Synthesis in Systematic reviews, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
High Versus Low Dose of Magnesium Sulfate as Initial Tocolytic Agent for Preterm Labour in Symptomatic Placenta Previa
The Possible Role of Hypoxia-induced Autophagy and Matrix Metalloproteinase-9 in the Pathogenesis of Morbidly Adherent Placenta.
Who cites it
2 citing papers in PubMed, 6 citations in OpenAlex.
- Differences between Current Clinical Practice and Evidence-Based Guideline Recommendations Regarding Tocolysis - an Austria-wide Survey.Geburtshilfe und Frauenheilkunde · 2025Article
- Prevention and Therapy of Preterm Birth. Guideline of the DGGG, OEGGG and SGGG (S2k Level, AWMF Registry Number 015/025, September 2022) - Part 2 with Recommendations on the Tertiary Prevention of Preterm Birth and on the Management of Preterm Premature Rupture of Membranes.Geburtshilfe und Frauenheilkunde · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPlacenta praevia refers to a placenta located in the lower segment of the uterus. This abnormal location predisposes the placenta to abnormal bleeding with an increased risk of premature labour. The merits of tocolytic drugs (tocolysis) to calm uterine contractions and prolong pregnancy in women with placenta praevia are uncertain.
objectivesThe primary objective is to determine the effects of tocolysis versus no tocolysis on pregnancy prolongation. Secondary objectives include to determining the effects of tocolysis versus no tocolysis on gestational age at delivery, maternal hospitalisations, recurrent vaginal bleeding, prematurity, admissions into neonatology, and perinatal deaths.
methodsWe searched MEDLINE, EMBASE, The Cochrane Central Register of Controlled Trials, reference lists of pertinent articles and trial registries for randomised controlled trials comparing tocolysis to no tocolysis or placebo in patients with placenta praevia. Risk of bias and data extraction was done independently by two reviewers. We pooled data using a random-effects model. We used the GRADE system to assess the certainty of evidence for each outcome. MAIN
resultsThere is no significant difference in pregnancy prolongation with the use of tocolysis in cases of placenta praevia (mean difference [MD] 11.51 days; 95% CI, - 1.75, 24.76; 3 trials, 253 participants; low certainty evidence). Tocolysis has no significant effect on gestational age at delivery (MD 0.33 weeks [95% CI - 1.53, 2.19]: 2 trials, 169 participants, moderate certainty evidence), birthweight (MD 0.12 kg [95% CI - 0.26, 0.5 kg]: 2 trials, 169 participants, moderate certainty evidence), risk of premature delivery (risk ratio [RR] 1.04; 95% CI 0.56, 1.94): 2 trials, 169 participants, low certainty evidence), risk of repeat vaginal bleeding (RR 1.05 [95% CI 0.73, 1.51]: 2 trials, 169 participants, moderate certainty evidence). Tocolysis has no significant effect on the risk of perinatal death (risk difference [RD]: 0.00 [95% CI - 0.04, 0.03]: 2 trials, 169 women; low certainty evidence), number of days of maternal hospitalisation (MD 0.60 days [95% CI - 0.79, 1.99]: 1 trial, 109 women; low certainty evidence), risk of fetal admissions into neonatology (RR 1.30 [95% CI 0.80, 2.12]: 1 trial, 109 participants, low certainty evidence) and on the duration of stay in neonatology units (MD 0.70 days [95% CI - 5.26, 6.66]: 1 trial, 109 participants, low certainty evidence).
conclusionIn women with symptomatic placenta praevia, there is no significant effect on pregnancy prolongation with the use of tocolysis. Tocolysis has no significant effect on other prenatal, perinatal, neonatal and maternal outcomes among women with symptomatic placenta praevia. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018091513.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.