***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To compare the efficacy and safety of nifedipine and ritodrine in preventing preterm labor , and to evaluate maternal side effects and neonatal outcome . STUDY DESIGN Non-blind , r and omized controlled trial RESULTS A r and omized trial of 102 pregnant women with gestational ages under 34 weeks , including 24 with twin pregnancies and 45 on betasympathicomimetic drugs , who had regular uterine contractions with either observed cervical changes or preterm rupture of membranes . After stratification women were r and omly assigned to receive either ritodrine intravenously or nifedipine orally . Fifty-five women were r and omized to the  nifedipine group and 47 to the  ritodrine  group . As expected , both groups were comparable in terms of several entry variables , including mean gestational age , ruptured membranes , treatment with tocolytic drugs , cervical examination , contraction frequency , age , and twin gestation . Delivery of women in the nifedipine group was delayed for 48 h , 7 days , and until 34 weeks gestation in 33 ( 60 % ) , 26 ( 47 % ) and 21(38 % ) cases , respectively , compared with 31 ( 66 % ) , 21(45 % ) and 11(23 % ) women in the ritodrine group ( no significant difference ) . Maternal side effects were significantly less common in the nifedipine group than in the ritodrine group , however after 7 days of therapy there was no difference between the two groups . Neonatal outcome was similar in the two groups , with four neonatal deaths in the nifedipine and five in the ritodrine group . CONCLUSIONS Nifedipine seems to be as effective as ritodrine in the treatment of preterm labor and is associated with less frequent side effects Ninety-six patients with preterm labor at 28 weeks to 35 weeks gestation were r and omized to terbutaline or magnesium sulfate untill 36 weeks gestation , 25 patients were excluded from the study . Of the remaining 71 patients , 35 patients received terbutaline and 36 patients received magnesium sulfate . The result of the study showed that , there were no significant differences ( P > 0.05 ) regarding time to stop , mean gestational age at delivery , time gained , failure rate , time to recurrent labor and readmission for recurrent labor , birth weight , apgar score and fetal survival . Serious maternal side effects were not observed with terbutaline or magnesium sulfate , although the majority of women also received dexamethasone . Neither drug caused serious adverse neonatal effects PURPOSE to compare the effectiveness of transdermal nitroglycerin with oral nifedipine in the inhibition of preterm delivery . METHODS a clinical essay has been performed with 50 women in preterm delivery , r and omly divided into two groups , 24 receiving  oral nifedipine ( 20 mg ) , and 26 , transdermal nitroglycerin ( 10 mg patch ) . Patients with a single gestation , between the 24th and the 34th weeks and diagnosis of preterm delivery were selected . Women with fetal malformation and clinical or obstetric diseases were excluded . The variables analyzed were : effective tocolysis , time needed for tocolysis , recurrence frequency , progression to preterm delivery , and side effects . RESULTS tocolysis efficacy in the first 12 hours was similar between the groups ( nitroglycerin : 84.6 % versus nifedipine : 87.5 % ; p=0.50 ) . The time average time needed for tocolysis was also similar ( 6.6 versus 5.8 hours ; p=0.30 ) . There was no difference between the groups , concerning the recurrence of preterm delivery ( 26.9 versus 16.7 % ; p=0.30 ) , and neither in the rate of preterm delivery within 48 hours ( 15.4 versus 12.5 % ; p=0.50 ) . Nevertheless , the cephalea rate was significantly higher in the Nitroglycerin Group ( 30.8 versus 8.3 % ; p=0.04 ) . CONCLUSIONS transdermal nitroglycerin has presented similar effectiveness to oral nifedipine to inhibit preterm delivery in the first 48 hours , however with higher cephalea frequency OBJECTIVE To compare the effectiveness and adverse effects of nifedipine versus indomethacin in the treatment of preterm labor . METHODS In a r and omized clinical trial , 79 women with labor pain at 26 - 33 weeks of gestation were treated with either oral nifedipine ( n=40 ) or rectal indomethacin ( n=39 ) . RESULTS Twenty-three ( 59 % ) women in the indomethacin group , and 10 ( 25 % ) in the nifedipine group did not respond to treatment ( P=0.002 ) . None of the 16 and 30 women remaining in the indomethacin and nifedipine groups , respectively , delivered during the subsequent 48 hours . Of these remaining women , 1 ( 6.25 % ) in the indomethacin group and 4 ( 13.3 % ) in the nifedipine group delivered between 48 hours and 7 days ( P=0.162 ) . For the women who responded to treatment , the mean gestational age at time of delivery was 238.5±19.4 days and 246.4±15.4 days in the nifedipine and indomethacin groups , respectively ( P=0.182 ) . Seventeen ( 42.5 % ) women in the nifedipine group , and 11 ( 28.2 % ) in the indomethacin group showed adverse effects ( P=0.184 ) . CONCLUSION Indomethacin was less effective than nifedipine for the fast treatment of preterm labor . For women who responded to treatment within 2 hours , however , the delaying of delivery by indomethacin was similar to that by nifedipine Mixed treatment comparison ( MTC ) meta- analysis is a generalization of st and ard pairwise meta- analysis for A vs B trials , to data structures that include , for example , A vs B , B vs C , and A vs C trials . There are two roles for MTC : one is to strengthen inference concerning the relative efficacy of two treatments , by including both ' direct ' and ' indirect ' comparisons . The other is to facilitate simultaneous inference regarding all treatments , in order for example to select the best treatment . In this paper , we present a range of Bayesian hierarchical models using the Markov chain Monte Carlo software WinBUGS . These are multivariate r and om effects models that allow for variation in true treatment effects across trials . We consider models where the between-trials variance is homogeneous across treatment comparisons as well as heterogeneous variance models . We also compare models with fixed ( unconstrained ) baseline study effects with models with r and om baselines drawn from a common distribution . These models are applied to an illustrative data set and posterior parameter distributions are compared . We discuss model critique and model selection , illustrating the role of Bayesian deviance analysis , and node-based model criticism . The assumptions underlying the MTC models and their parameterization are also discussed OBJECTIVE to establish the efficacy and safety of nifedipine and magnesium sulfate in arresting preterm labor . METHOD seventy-four patients with singleton pregnancies at 23 - 36 weeks in preterm labor , were selected r and omly to receive either oral nifedipine or intravenous magnesium sulfate . RESULTS both drugs had similar tocolytic efficacy and side effects while nifedipine was faster than magnesium sulfate in arresting uterine contractions ( 4.8 + /- 4.23 vs. 2.98 + /- 3.03 h ) P = 0.04 . CONCLUSION this data suggests that oral nifedipine with the same efficacy , side effects and faster action could be a suitable and more convenient alternative to intravenous magnesium sulfate in arresting preterm labor In a multicenter series of r and omized prospect i ve doubleblind controlled studies , ritodrine hydrochloride was compared with either ethanol or placebo in treatment of idiopathic preterm labor . When compared with controls , there was , among offspring of ritodrine-treated mothers , a significantly reduced incidence of neonatal death and respiratory distress syndrome ( P<.05 in both comparisons ) and a significantly higher proportion of infants achieving 36 weeks ' gestation ( P<.05 ) or birth weight greater than 2500 g ( P<.05 ) . There was also a significant improvement in gestational age at delivery ( P<.05 ) and in the number of days gained in utero ( P<.001 ) among ritodrine-treated patients as compared with controls . These results , coupled with a finding of generally acceptable side effects , have contributed to ritodrine 's becoming the first drug approved for the treatment of preterm labor in the United OBJECTIVE This study was undertaken to assess the effectiveness of glyceryl trinitrate ( GTN ) patches in comparison with beta2 sympathomimetics ( beta2 ) for the treatment of  preterm labor .  STUDY DESIGN A multicenter , multinational , r and omized controlled trial was conducted in tertiary referral teaching hospitals . Women in threatened preterm labor with positive fetal fibronectin or ruptured membranes between 24 and 35 weeks ' gestation were recruited and r and omly assigned to either beta2 or GTN with rescue beta2 tocolysis if moderate-to-strong contractions persisted at 2 hours . Obstetric and neonatal outcomes were assessed . RESULTS Two hundred thirty-eight women were recruited and r and omly assigned , 117 to beta2 and 121 to GTN . On a strict intention-to-treat basis , there was no significant difference in the time to delivery using Kaplan-Meier curves ( P = .451 ) . At 2 hours , 27 % of women receiving beta2 had moderate or stronger contractions compared with 53 % in the GTN group ( P < .001 ) . This led to 35 % of women in the GTN group receiving rescue treatment . If delivery or requirement for beta2 rescue are regarded as treatment failure , then a significant difference was observed between the 2 arms ( P = .0032 ) . There were no significant differences in neonatal outcomes . CONCLUSION GTN is a less efficacious tocolytic compared with ss2 sympathomimetics Objective To compare a new loading dose regimen for intravenous ritodrine administration in preterm labour with the conventional dose regimen The authors compare the efficiency of two drugs in the treatment of threatened premature labour , the one being the calcium inhibitor ( nifedipine ) and the other a beta-mimetic drug ( ritodrine ) . 62 patients after r and om selection were divided into two groups : 32 treated with ritodrine and 30 treated with nifedipine . The treatment was carried out over 7 days . The success rate was similar in both groups -72 % for the ritodrine group and 63.33 % for the nifedipine group . Women receiving nifedipine had slightly greater gain in weeks , six as against five for ritodrine . The side effects which were often found with nifedipine were ; hot flushes ( in 10 cases ) and headaches ( 4 cases ) . These symptoms appeared 15 - 30 minutes after the first dose and were transitory . No neonatal complications were found . The ease with which a calcium inhibitor can be given suggests that it should be used more frequently in the treatment of threatened premature labour and particularly when there are contra-indications to the use of beta-mimetic drugs One hundred six patients in preterm labor with intact amniotic membranes and gestational age less than or equal to 32 weeks were r and omized to receive either ritodrine hydrochloride or a 48-hour course of indomethacin for tocolysis . The relative efficacy , maternal and neonatal safety , and costs were evaluated to determine which may be the more appropriate first-line pharmacologic agent used to manage preterm labor . Fifty-four patients and 52 patients were r and omized to receive ritodrine hydrochloride or indomethacin  , respectively .  Ritodrine hydrochloride and indomethacin were equally effective in inhibiting uterine contractions and delaying delivery . Delivery was delayed for at least 48 hours in 83 and 94 % , and for at least 7 days in 70 and 75 % of patients receiving ritodrine or indomethacin , respectively . Tocolysis with indomethacin was associated with no maternal side effects , whereas tocolysis with ritodrine hydrochloride was associated with a 24 % incidence of serious cardiovascular and metabolic adverse effects prompting discontinuation of the drug . There were no differences in outcome between the infants exposed to indomethacin versus ritodrine hydrochloride when delivered either remote from therapy or during therapy , except for a statistically higher serum glucose in the infants exposed to ritodrine hydrochloride when delivered during tocolytic therapy . There were no cases of premature closure of the ductus arteriosus or pulmonary hypertension . Tocolysis with indomethacin was 17 times less costly than tocolysis with ritodrine hydrochloride . For gestations less than or equal to 32 weeks complicated by preterm labor , indomethacin may be an appropriate alternative as a first-line tocolytic agent One hundred women in preterm labor were r and omly treated with ritodrine or terbutaline in a double-blind fashion . The drugs were comparably effective during intravenous therapy but , in women with intact membranes , an oral dose of terbutaline 
    Output:
    
No class of tocolytic was significantly superior to placebo in reducing neonatal respiratory distress syndrome .
Prostagl and in inhibitors and calcium channel blockers were the tocolytics with the best probability of being ranked in the top three medication classes for the outcomes of 48 hour delay in delivery , respiratory distress syndrome , neonatal mortality , and maternal side effects ( all cause ) .
Conclusions Prostagl and in inhibitors and calcium channel blockers had the highest probability of delaying delivery and improving neonatal and maternal outcomes