Tocolysis:An Update for the Practitioner

Rodts-Palenik, Sheryl; Morrison, John C.

doi:10.1097/00006254-200205001-00001

Cited by 20 publications

(8 citation statements)

References 163 publications

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“…Postponement of pregnancy for at least 48 hours allows the corticosteroids to reach their maximum effect for reducing RDS and its sequelae, as well as IVH 9. Previous studies have shown that both subcutaneous terbutaline10–12 and intravenous salbutamol13–15 are effective tocolytic agents for patients with PTL.…”

mentioning

confidence: 99%

Terbutaline versus salbutamol for suppression of preterm labor: a randomized clinical trial

Motazedian

Ghaffarpasand

Mojtahedi

et al. 2010

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVE:Preterm labor (PTL) is a common medical problem during pregnancies and is associated with neonatal mortality and morbidity. Beta-adrenergic agonists are among the most commonly used tocolytic agents. The aim of this study was to compare the effectiveness, safety and adverse effects of terbutaline with those of salbutamol in the prolongation of pregnancy beyond 48 hours and until 37 weeks of gestation.PATIENTS AND METHODS:Two hundred women with PTL were randomly assigned to receive subcutaneous terbutaline (250 μg) or intravenous salbutamol (0.1 mg) followed by oral terbutaline (20 mg/d) or oral salbutamol (24 mg/d) as maintenance. The efficacy, side effects and complications after 48 hours and until 37 weeks of gestation were analyzed and compared.RESULTS:There was no significant difference between the two groups in success rate within 48 hours (P=.091). Gestational age at delivery (P=.031) and the number of days for which the gestation was prolonged (P=.024) were significantly higher in those receiving terbutaline. Adverse effects, including tachycardia (P=.007) and anxiety (P=.006), were experienced more in the salbutamol group. Birth weight was significantly lower in the salbutamol group (P=.001).CONCLUSION:Terbutaline provided more effective tocolysis with fewer adverse effects and a better neonatal outcome. However, terbutaline and salbutamol are equally effective in the first 48 hours.

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confidence: 99%

Terbutaline versus salbutamol for suppression of preterm labor: a randomized clinical trial

Motazedian

Ghaffarpasand

Mojtahedi

et al. 2010

Annals of Saudi Medicine

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“…He also reported that isoxsuprine caused nausea in 22 -30% of the patients and palpitation and tachycardia in 50% of the patients. [11] In this studies, transient hypotension was seen in 17% of the patients treated with nifedipine as compared to 23% of the patients treated with isoxsuprine. Tachycardia was seen in 32% and 77% of the patients on nifedipine and isoxsuprine respectively.…”

Section: Discussionmentioning

confidence: 59%

Comparative Study of Isoxsuprine and Nifedipine in the Management of Preterm Labour

Vanremmawii¹,

Lalrinfela²

2018

AIMDR

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Background: The purpose of the study was to compare the efficacy of Isoxsuprine and Nifedipine as tocolytic agent on preterm labour and to compare the Obstetrical outcome following Isoxsuprine and Nifedipine therapy as a tycolytic agent. Methods: The study which was randomized prospective study, comprised of 100 patients with preterm labor, admitted in antenatal ward of State Referral Hospital, Falkawn, Mizoram during the period of January 2015 to December 2017. The Patients who fullfield the inclusion criteria for the study were divided into 2 groups; group-A consisted of 48 patients, treated with Nifedipine for tocolysis, the group-B consisted of 52 patients, who received isoxsuprine for tocolysis, and were monitored throughout the course of treatment. Result: Successful tocolysis was achieved by Nifedipine in 77.1% of the case as compared to 67% with the isoxsuprine treated cases. And Nifedipine prolonged pregnancy for 15.427±12.875 days while Isoxsuprine prolonged pregnancy for 13.356±13.612 days. Apgar score of babies less than 7 was 33.3% in Group-A and 32.6% in Group-B. The incidence of perinatal death (16%) in group-A is lower as compared to (19.6%) group-B. Conclusion: Nifedipine is more effective tocolytic agent, as compared to Isoxsuprine. The neonatal outcome with respect to birth weight, Apgar score and perinatal death were better in the cases treated with nifedipine as compared to Isoxsuprine.

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“…Oral or sublingual nifedipine administration for treatment of acute preterm labor has been the subject of many small nonrandomized prospective trials and meta-analysis [67]. More recently, nifedipine was studied for maintenance tocolysis in randomized clinical trials which have demonstrated no difference in outcome between the study drug and the control group [8, 68, 69].…”

Section: Oral Maintenance Therapymentioning

confidence: 99%

“…While antiprostaglandin drugs, administered as suppositories or orally, have long been accepted as primary and secondary treatment for acute preterm labor, there is no data regarding the use of these drugs for maintenance therapy [67]. Even, when used at <32 weeks and <48 hours in a treatment cycle, the incidence of oligohydramnios and ductal constriction are too high to justify its use as maintenance treatment after arrest of acute preterm labor [74].…”

Section: Oral Maintenance Therapymentioning

confidence: 99%

The Evidence Regarding Maintenance Tocolysis

Elliott¹,

Morrison

2013

Obstetrics and Gynecology International

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Preterm delivery is a public health issue of major proportion. More than 12% of deliveries in the United States that occur at less than 37 weeks gestation preterm labor (PTL) represents the largest single reason for preterm birth (PTB). Attempts to prevent PTB have been unsuccessful. This paper of maintenance tocolytic therapy will examine the efficacy and safety of the drugs, both oral and subcutaneous, which have been utilized for prolongation of pregnancy following successful arrest of a documented episode of acute preterm labor. The evidence for oral tocolytics as maintenance therapy as well as parenteral medications for such patients is offered. Finally, the effects in the United States of the Food and Drug Administration (FDA) action on such medications are reported.

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Tocolysis:An Update for the Practitioner

Cited by 20 publications

References 163 publications

Terbutaline versus salbutamol for suppression of preterm labor: a randomized clinical trial

Terbutaline versus salbutamol for suppression of preterm labor: a randomized clinical trial

Comparative Study of Isoxsuprine and Nifedipine in the Management of Preterm Labour

The Evidence Regarding Maintenance Tocolysis

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