Betamimetic drugs in the prophylaxis of preterm labour: extent and rationale of their use

A questionnaire survey among 1004 specialist and trainee obstetricians in The Netherlands and northern Belgium (Flanders), revealed that 45% of the 521 (52%) respondents would use prophylactic betamimetics to prevent preterm labour. A further 33% would only use them as maintenance therapy after an acute episode of preterm labour. Only 22% would use neither form of prophylaxis, 23% would not prescribe oral betamimetics for out-patients, and a mere 12% would use neither prophylaxis nor out-patient treatment. Nevertheless, only 4% of those using betamimetics either prophylactically or as maintenance therapy said that they were very effective. The data indicate that a large body of obstetricians will resort to dubious treatments with poor effectiveness and unknown risks in an attempt to avoid the known risks of a condition for which aetiological insight and effective therapy are lacking.