Tocolysis for acute preterm labor: does anything work

  title={Tocolysis for acute preterm labor: does anything work},
  author={Kjell Haram and Jan Helge Seglem Mortensen and John Morrison},
  journal={The Journal of Maternal-Fetal \& Neonatal Medicine},
  pages={371 - 378}
Abstract The central rationale of tocolysis for preterm labor (PTL) is to delay delivery for at least 48 h to allow for transfer of the mother to a tertiary facility and for corticosteroids to induce surfactant production in fetal lungs. Beta-mimetics decrease the number of women in preterm labor giving birth within 48 h without reducing adverse neonatal outcomes. Calcium channel blockers inclusive of nifedipine decrease the adverse neonatal outcomes by significantly delaying delivery. Atosiban… 

Acute Tocolysis – a Critical Analysis of Evidence-Based Data

Atosiban is as effective for prolonging pregnancy as beta sympathomimetics and nifedipine, has the lowest rate of maternal adverse effects, but also the highest drug costs, and there are indications of increased neonatal morbidity following indomethacin.

Pharmacology for Preterm Labor.

Preterm birth occurs with 10% of deliveries and yet accounts for more than 85% of perinatal morbidity and mortality. Management of preterm labor prior to delivery includes a multipronged

Hexoprenaline Compared with Atosiban as Tocolytic Treatment for Preterm Labor

A retrospective study shows a significantly higher efficacy of atosiban in the first 48 hours, especially when administered at an early gestational age, compared with hexoprenaline.

Evaluation of transdermal nitroglycerine as tocolytic agent in preterm labour

Evaluating the efficacy and safety of transdermal nitroglycerin as tocolytic agent in women with preterm labor found TNG appear to be at least as effective as the commonly used to colytics today.

Plausibility of the combination of 17 α hydroxyprogesterone injection and Nifedipine versus Magnesium sulfate in the management of preterm labor, RCT

To compare the effectiveness of the tocolytic action of the standard protocol of Magnesium sulfate versus the combination of Nifedipine and 17 α hydroxyprogesterone injection in the term of acute to colysis therapy on the perinatal outcome and to abrupt threatened preterm labor between 24 weeks to 33 weeks and 6 days.

Success rate in preterm uterine contraction inhibition with tocolytic agents in a tertiary care center

The success rate of inhibiting preterm uterine contraction inhibition with tocolytic agents to delay delivery for at least 48 hours was high in threatened pre term labor and low in preterm labor.

Tocolysis for in utero Surgery: Atosiban Performs Distinctly Better than Magnesium Sulfate

The authors suggest using atosiban instead of magnesium sulfate in the context of open fetal surgery, as it resulted in an almost identical short-term uterine outcome without any serious maternal complications as seen when magnesium sulfATE was given.

Cyclooxygenase inhibitors for treating preterm labour: What is the molecular evidence? 1.

It is determined that there is insufficient evidence to support or refute a role of COX-1/-2 in the onset of preterm labour that supportsCOX-targeted tocolysis, and existing scientific evidence is searched to address the hypothesis that COX expression/activity is increased withthe onset of human labour.

Comparative study of nitroglycerin dermal patch versus nifedipine in the management of preterm labour

Nifedipine was found to be superior to nitroglycerin dermal patch in prolongation of gestational age at the time of delivery, in perinatal outcome and maternal acceptance.

Factors associated with higher oxytocin requirements in labor

  • H. FreyM. Tuuli A. Cahill
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2015
Few women who achieve complete cervical dilation require high doses of oxytocin, according to a retrospective nested case-control study performed within a cohort of all term women at a single center between 2004 and 2008.



Controversies in tocolytic therapy.

It is doubtful, because of the nature of tocolytics, that newer to colytics will be developed that will eliminate the problems of preterm delivery, but careful guidelines must be observed.

Use of tocolytics: what is the benefit of gaining 48 hours for the fetus?

There is ample evidence that tocolysis delays delivery for long enough to permit administration of a complete course of antepartum glucocorticoids and to facilitate in utero transfer to a tertiary care unit where neonatal care will be optimal.

Management of preterm labor: atosiban or nifedipine?

The available evidence, the pros and cons of either drug, and information to support a balanced choice of first-line tocolytic drug: atosiban or nifedipine are discussed.

Prematurity prevention: the role of acute tocolysis

This review will summarize the most common acute tocolytic drugs, their methods of action, and clinical data regarding their utility.

Preterm labour. Pharmacological prevention of prematurity.

  • K. Groom
  • Medicine
    Best practice & research. Clinical obstetrics & gynaecology
  • 2007
The acute treatment of premature labour is successful for delaying delivery for short periods of time, and the use of progesterone in women with a history of very early preterm labour is likely to be beneficial for preventing pre term labour.


  • Medicine
  • 2003
Preterm birth is the most important single determinant of adverse infant outcome, in terms of both survival and quality of life. Although preterm birth is defined as being before 37 completed weeks,

Effect of antenatal tocolysis on neonatal outcomes

  • C. KlauserC. BrieryS. KeiserRick W. MartinM. KosekJ. Morrison
  • Medicine
    The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
  • 2012
There were no statistically significant differences between the three tocolytic drugs as far as composite neonatal morbidity or mortality was concerned.

The choice of a tocolytic for the treatment of preterm labor: a critical evaluation of nifedipine versus atosiban

Atosiban was developed specifically to treat preterm labor, so the cost is higher than nifedipine or ritodrine, but the balance of evidence indicates that atosiban is as effective as nifesiban and more effective than β-agonists and is significantly safer than both.

Nifedipine in the management of preterm labor: a systematic review and metaanalysis.