The Effect of metronidazole, erythromycin and indomethacin on the process of idiopathic preterm labor

Approximately 39%-61%of cases with idiopathic preterm labor (IPL) fail to respond to tocolytic therapy to increase this response many different antibiotics have tried but mostly the effect on suppression of IPL has been minimal. This study was conducted to investigate whether addition of antiprostaglandins to the antibiotic regimen could suppress IPL A double blind randomized clinical trial was performed. Forty-nine women with IPL at 24-34weeks of pregnancy were selected and divided into two groups of 25 cases and 24 controls by random allocation. Experimental cases received indomethacin with antibiotics while the controls were given similar antibiotics with placebo. Outcome variables were delay in delivery for 24 hours, carrying the pregnancy up to 37weeks, comparison of birth weight and need for NICU admission. Statistical analysis was done by Chi square, T test and Fisher exact tests. Delay in delivery for 24 hour was 84%, (n=21), in cases and 79%, (n=19), in controls, (p=0.1). 32%, (n=8) of cases vs. 20.8% of controls carried the pregnancy up to 37 weeks, (p=0.8). Mean birth weight in cases and controls were 2273.3+863 vs. 20113+529gr, (p=0.9). Need for NICU admission was 4 days in cases vs. 8days in controls. In each group 2 neonates died. In this study, the combination of antiprostaglandins, (indomethacin), and antibiotics, (metronidazole-erythromycin), did not have a significant effect on suppression of IPL.