***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 OBJECTIVE The objective was to compare the effectiveness , efficacy , and safety of atosiban and nifedipine in preventing or delaying  premature labor .  DESIGN An interventional , r and omized , controlled trial of 63 women experiencing preterm labor varying from 24 to 35 completed weeks of gestation . The women were r and omized to receive either atosiban intravenously ( group I , n=31 ) , or nifedipine orally ( group II , n=32 ) . RESULTS There were no significant differences in effectiveness and efficacy of tocolysis between the two groups . Women with a history of preterm labor responded significantly better to atosiban than those with no such history . Those at 28 weeks or less responded significantly better to nifedipine , while those at more than 28 weeks ' gestation showed an equal response in the two groups . Nifedipine achieved uterine quiescence in a significantly shorter time than atosiban . The maternal side effects were higher with nifedipine . Neonatal complications were comparable in both groups . CONCLUSIONS Both drugs are equally effective and efficacious in acute tocolysis . Subgrouping of patients according to gestational age and history of preterm labor may be applied in selecting the line of treatment . The maternal side effects were higher with nifedipine OBJECTIVE To perform a comparison between atosiban ( oxytocin antagonist ) and nifedipin ( calcium channel blocker ) for acute treatment of preterm labor and their maternal safety . METHODS A r and omized controlled trial study was performed on 80 pregnant women with preterm labor , between 26 and 34 weeks of pregnancy , in Akbar Abadi Teaching Hospital in Tehran , Iran . 40 women ( the atosiban group ) were compared with another 40 women ( the nifedipin group ) for the drugs ' efficacy in delaying delivery for more than 48 h in order to undergo steroid therapy , and for more than 7 days or more , and also to assess their maternal safety . The duration between the drugs ' administration and delivery were compared . The statistical analysis was performed using the Statistical Package for Social Science ( SPSS ) . RESULTS There was no statistically significant difference between the two groups in the treatment of preterm labor .  Atosiban was effective in 82.5 % of cases , and nifedipin in 75 % of the cases ( p=1.000 ) , for delaying delivery for 48 h. Atosiban was effective in 75 % of the cases , and nifedipin in 65 % of the cases , for delaying delivery for more than 7 days . The maternal side effects in the atosiban group were 17.5 % , and in the nifedipin group they were 40 % , which had a statistically significant difference ( p=0.027 ) . The duration between treatment and delivery was 29.03+/-16.12 days in the atosiban group and 22.85+/-13.9 days in the nifedipin group with no statistically significant difference ( p=0.79 ) . CONCLUSION Atosiban is an effective and safe drug for the acute treatment of preterm labor with minimal side effects , and it can be an option in the treatment of preterm labor , especially in patients with heart disease and multi-fetal pregnancies The purpose of this study was to describe the course of  preterm labor in patients receiving a st and ard intravenous infusion of the oxytocin antagonist atosiban .  An open-labeled , non-r and omized study was conducted at 4 sites . Successful tocolysis was defined as delay of delivery larger than 48 hours from starting atosiban and no need for an alternate tocolytic . Atosiban was administered by continuous intravenous infusion at a rate of 300 micrograms per minute until uterine contractions were absent for 6 hours , or up to a maximum infusion time of 12 hours . Sixty-two patients of between 20 and 36 weeks ' gestation were enrolled over 6 months . One had rupture of membranes and was excluded .  Successful tocolysis was noted in 43 of 61 ( 70.5 % ) . Four delivered spontaneously within 48 hours and 14 ( 23.0 % ) required an alternate tocolytic agent . The chance of successful tocolysis was related to the degree of cervical dilation at the start of therapy . Cessation of uterine contractions was noted in 38 patients ( 62.3 % ) . A decrease in uterine contraction frequency of 50 % or more was noted in 50 of 61 patients ( 82.0 % ) . Four patients reported side effects ( nausea , vomiting , headache , dysguesia , chest pain ) , but in no case did side effects require discontinuation of the medication . Intravenous administration of atosiban is associated with a delay in delivery comparable to that seen with other tocolytics . If this effect is confirmed in planned placebo-controlled trials , its favorable side effect profile may give it a place in the armamentarium A phase IV multinational , multicentre study has been design ed -- the Tractocile Efficacy Assessment Survey in Europe ( TREASURE ) . The aim is to assess atosiban in the clinical setting , which is associated with fewer restrictions than in phase III trials . Atosiban is to be compared with ' usual care ' in women eligible for treatment , and will also be evaluated as deferred or immediate treatment in women who have not yet fulfilled the diagnostic criteria for pre-term labour . Exploring the use of atosiban beyond the normal indications may allow the identification of additional sub population s of women who will benefit from early treatment . TREASURE will offer data on new diagnostic tools , investigate respiratory distress syndrome according to severity and record the use of antenatal steroids . It is hoped that additional information concerning the subtle differences in clinical practice will broaden our underst and ing of how to manage  pre-term labour and offer the chance to revise treatment guidelines Abstract Objective : To compare the efficacy of atosiban with usual management of  threatened preterm labor .  Methods : In this prospect i ve , open-label , r and omized controlled trial , women admitted to the hospital in threatened preterm labor ( between 24 and 34 weeks ' gestation ) were r and omized to receive atosiban or usual care ( β-agonists , calcium channel blockers , magnesium sulphate , or any other tocolytic , alone or in combination , and /or bed rest ) . Results : In women r and omized to receive atosiban ( n=295 ) or usual care ( n=290 ) , significantly more women receiving atosiban remained undelivered at 48 h with no alternative tocolytic compared with usual care ( 77.6 % vs. 56.6 % ; P<0.001 ) . The proportion of women remaining undelivered after 48 h was comparable between the treatment groups . However , more women in the atosiban group required no additional tocolytics ( 85.1 % vs. 62.8 % ; P<0.001 ) . Maternal and fetal safety was significantly superior with atosiban  . Neonatal safety was comparable . Conclusions : These findings support the use of atosiban to delay preterm birth and are consistent with previously conducted , r and omized , controlled trials . Atosiban was associated with fewer maternal and fetal adverse events compared with other tocolytics , and presented no safety concerns for either the mother or the unborn baby Objective To compare the effects of four methods of analysis on the results of r and omised controlled trials that recruit women with multiple pregnancies and measure outcomes on their babies OBJECTIVE Our aims were to develop a risk assessment system for the prediction of spontaneous preterm delivery using clinical information available at 23 to 24 weeks ' gestation and to determine the predictive value of such a system . STUDY DESIGN A total of 2929 women were evaluated between 23 and 24 weeks ' gestation at 10 centers . Demographic factors , socioeconomic status , home and work environment , drug and alcohol use , and medical history were evaluated . Information regarding symptoms , cultures , and treatments in the current pregnancy were ascertained . Anthropomorphic and cervical examinations were performed . Univariate analysis and multivariate logistic regression were performed in a r and om selection , constituting 85 % of the study population . The derived risk assessment system was applied to the remaining 15 % of the population to evaluate its validity . RESULTS A total of 10.4 % of women were delivered of preterm infants . The multivariate models for spontaneous preterm delivery were highly associated with spontaneous preterm delivery ( p < 0.0001 ) . A low body mass index ( < 19.8 ) and increasing Bishop scores were significantly associated with spontaneous preterm delivery in nulliparous and multiparous women . Black race , poor social environment , and work during pregnancy were associated with increased risk for nulliparous women . Prior obstetric outcome overshadowed socioeconomic risk factors in multiparous women with a twofold increase in the odds of spontaneous preterm delivery for each prior spontaneous preterm delivery . Current pregnancy symptoms , including vaginal bleeding , symptomatic contractions within 2 weeks , and acute or chronic lung disease were variably associated with spontaneous preterm delivery in nulliparous and multiparous women . When the system was applied to the remainder of the population , women defined to be at high risk for spontaneous preterm delivery ( > or = 20 % risk ) carried a 3.8-fold ( nulliparous women ) and 3.3-fold ( multiparous women ) higher risk of spontaneous preterm delivery than those predicted to be at low risk . However , the risk assessment system identified a minority of women who had spontaneous preterm deliveries . The sensitivities were 24.2 % and 18.2 % and positive predictive values were 28.6 % and 33.3 % , respectively , for nulliparous and multiparous women . CONCLUSIONS Although it is possible to develop a grade d risk assessment system that includes factors that are highly associated with spontaneous preterm delivery in nulliparous and multiparous women , such a system does not identify most women who subsequently have a spontaneous preterm delivery . This system has investigational value as the basis for evaluating new technologies design ed to identify at-risk sub population OBJECTIVES This study was design ed to evaluate the efficacy and safety of the oxytocin receptor antagonist atosiban in the treatment of preterm labor . STUDY DESIGN A multicenter , double-blind , placebo-controlled trial with tocolytic rescue was design ed . Five hundred thirty-one patients were r and omized to receive , and 501 received , either intravenous atosiban  ( n = 246 ) or placebo ( n = 255 ) , followed by subcutaneous maintenance with the assigned agent . St and ard tocolytics as rescue tocolysis were permitted after 1 hour of either placebo or atosiban if preterm labor continued . The primary end point was the time from the start of study drug to delivery or therapeutic failure . Secondary end points were the proportion of patients who remained undelivered and did not receive an alternate tocolytic at 24 hours , 48 hours , and 7 days . RESULTS No significant difference was found in the time from start of treatment to delivery or therapeutic failure between atosiban and placebo ( median , 25.6 days vs 21.0 days , respectively ; P = .6 ) . The percentages of patients remaining undelivered and not requiring an alternate tocolytic at 24 hours , 48 hours , and 7 days were significantly higher in the atosiban group than in the control group ( all P < or = .008 ) . A significant treatment-by-gestational age interaction existed for the 48-hour and 7-day end points . Atosiban was consistently superior to placebo at a gestational age of > or = 28 weeks . Fourteen atosiban-treated patients and 5 placebo-treated patients were r and omized at < 24 weeks ; the incidence of fetal-infant death 
    Output:
    
This review failed to demonstrate the superiority of atosiban over betamimetics or placebo in terms of tocolytic efficacy or infant outcomes .
A recent Cochrane review suggests that calcium channel blockers ( mainly nifedipine ) are associated with better neonatal outcome and fewer maternal side-effects than betamimetics .