Betamimetics for inhibiting preterm labour

Abstract

Betamimetics help to delay birth, which may give time to allow women to be transferred to tertiary care or to complete a course of antenatal corticosteroids. However, multiple adverse effects must be considered. The data are too few to support the use of any particular betamimetic.

Assessment of side effects of generic injectable ritodrine hydrochloride products

“…Especially in Japan, ritodrine has been used to prolong pregnancy as much as possible, 6) while in most western countries, it is restrictively and temporarily used to maintain pregnancy for a period less than 48 hours, which is long enough to allow women to be transferred to tertiary care or to complete a course of antenatal corticosteroids for the maturation of fetal lungs. 7) In many countries including Japan, a DPC-based fixed payment system for hospitalization costs has been introduced to the health insurance system, which prioritizes economic efficiency. As such, changes from original to generic drugs are frequently demanded.…”

Tocolysis – update 2016

“…Dies Beispiel zeigt auf, dass alleine der Zulassungsstatus eines Medikamentes in der Praxis z. T. recht wenig mit aktuellen, evidenzbasierten Therapieempfehlungen gemeinsam haben kann. β-Sympathomimetika können effektiv die Geburt herauszögern, um einen Zyklus Lungenreifeprophylaxe zu ermöglichen, die Datenlage reicht aber nicht aus, um eine bestimmte Substanz besonders zu empfehlen [43]. Verglichen mit Kalziumantagonisten führen β-Sympathomimetika zu mehr maternalen Nebenwirkungen, einer geringeren Schwangerschaftsprolongation sowie hö-herer fetaler Mortalität [28].…”

“…Zu den unter β-Sympathomimetika signifikant vermehrt auftretenden, relevanten Nebenwirkungen zählen v. a. Brustschmerz und Dyspnoe sowie Palpitationen, Tachykardie (auch fetal), Kopfschmerz und Hyperglykämien [43]. Eine maternale Hyperglykämie kann im Falle einer zeitnahen Entbindung zu einer reaktiven fetalen Hypoglykämie führen.…”

Preterm Labor

“…[2][3][4][5][6][7] The decision as to which tocolytic agent should be used as first-line therapy for an individual patient should be based on multiple factors, including efficacy, gestational age, presence of maternal comorbidities, and the frequency and severity of side effects.…”