Preterm labor: current pharmacotherapy options for tocolysis

Vliet, Elvira O.G. van; Boormans, Elisabeth M.; Lange, Thomas S. de; Mol, Ben Willem; Oudijk, Martijn A.

doi:10.1517/14656566.2014.889684

Cited by 31 publications

(29 citation statements)

References 52 publications

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“…Preterm delivery is the most common cause of neonatal morbidity and mortality [1,2,3]. Since preterm contractions correlate highly with preterm delivery, their inhibition by tocolysis constitutes a major element in the corresponding treatment [4].…”

Section: Introductionmentioning

confidence: 99%

Two Randomised Clinical Trials on the Use of Bryophyllum pinnatum in Preterm Labour: Results after Early Discontinuation

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Two Randomised Clinical Trials on the Use of Bryophyllum pinnatum in Preterm Labour: Results after Early Discontinuation

et al. 2018

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“…The most commonly used drugs for tocolysis are β2-adrenoceptor agonists (ritodrine), calcium channel blockers (nifedipine), oxytocin receptor antagonist (atosiban), prostaglandin inhibitors (indomethacin) and magnesium sulfate [5]. There is evidence suggesting that calcium-channel blockers are preferable to other drugs for tocolysis [6]. Calcium channel blockers were shown to have benefits over betamimetics with respect to prolongation of pregnancy, serious neonatal morbidity, and maternal adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Nicardipin Associated Pulmonary Edema : A Severe Complication of Tocolysis - A Case Report

et al. 2018

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In preterm labor, tocolytics are used to stop uterine contractions and to allow the administration of corticosteroids for fetal lung maturation, nicardipine is a calcium channel blocker increasingly used for this indication. Several adverse effects have been reported during tocolysis using nicardipine, one of the most serious complications is Acute Pulmonary Edema. We report a case of a parturient who was admitted at 28 weeks pregnancy for preterm labor and developed a respiratory failure two days following tocolysis with nicardipine. Echocardiography and Computed Tomography Pulmonary Angiography (CTPA) ruled out a pulmonary embolism and a decompensated heart disease. The patient received oxygen therapy and diuresis for Acute Pulmonary Edema with favorable outcome. The purpose of this paper is to discuss the risk factors for occurrence of pulmonary edema after tocolysis, importance of etiologic investigation to exclude differential diagnoses and therapeutic options for management of this complication.

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“…12 The treatment of women at risk of preterm delivery consists of administration of tocolytic drugs in order to delay labor for 48 hours to facilitate for administration of corticosteroids and transportation of the patient to a center with NICU facilities especially if gestational age is <32 weeks. 13 Isoxsuprine, which is a beta-adrenergic agonist and a potent vasodilator, was actually the first drug to be published as a tocolytic agent to prevent uterine contractions.…”

Section: Discussionmentioning

confidence: 99%

Practice patterns in the management of preterm labor in India: a multi-centric, retrospective study

Jaju

Sood

Chavan

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Preterm labor (PTL) is considered as one of the leading cause of perinatal morbidity and mortality. Preterm labor refers to the onset of uterine contractions of sufficient strength and frequency to effect progressive dilatation and effacement of cervix between 22 and 37 weeks of gestation. Methods: In this study, 285 patients of PTL admitted/treated (during the period of 1 st January 2014 to 31 st December 2016) across 5 centres in India were enrolled. Adult women with PTL, receiving oral or intravenous regime of tocolytic drugs were screened based on eligibility criteria. Results: We evaluated the practice patterns in the management of PTL in India. The pharmacological management (n=193) was preferred over nonpharmacological management (n=92) in the present study. Amongst the pharmacological agents, isoxsuprine (60.10%) was more frequently used followed by nifedipine (23.83%). Prolongation of delivery for at least 48 hours was observed in 57.76% patients receiving isoxsuprine compared to 34.78% patients receiving nifedipine. The mean latency period (36.77±28.09 vs. 1.44±1.33 days), birthweight (2.25±1.34 vs. 1.07±0.34 kg) and Apgar score at 5 mins (7.56±2.36 vs. 4.87±2.10) was higher for isoxsuprine compared to nifedipine group patients, with mean gestational age of <32 weeks (extreme to very PTL cases; p<0.0001). Similar results were observed in latency period and Apgar score between isoxsuprine and nifedipine groups in late PTL cases (>32 weeks). Conclusions: Pharmacological treatment was preferred for the management of PTL in India. Among pharmacological agents, isoxsuprine was preferred over other tocolytics. Significant improvement in mean latency period, prolongation of delivery beyond 48 hours and perinatal outcomes were noted amongst patients on isoxsuprine versus other pharmacological agents.

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Preterm labor: current pharmacotherapy options for tocolysis

Cited by 31 publications

References 52 publications

Two Randomised Clinical Trials on the Use of <b><i>Bryophyllum pinnatum</i></b> in Preterm Labour: Results after Early Discontinuation

Two Randomised Clinical Trials on the Use of <b><i>Bryophyllum pinnatum</i></b> in Preterm Labour: Results after Early Discontinuation

Nicardipin Associated Pulmonary Edema : A Severe Complication of Tocolysis - A Case Report

Practice patterns in the management of preterm labor in India: a multi-centric, retrospective study

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