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Do tocolytic agents stop preterm labor? A critical and comprehensive review of efficacy and safety

Higby K et al., 1993

American journal of obstetrics and gynecology, 168(4), 1247-1259

DOI 10.1016/0002-9378(93)90376-t PMID 8097367 Source

Abstract

Objective

Our aim was to determine the efficacy and safety of tocolytic agents currently used to treat premature labor.

Study design

We carried out a comprehensive review of tocolytic agents in the treatment of premature labor. Three hundred twenty-eight studies published between 1933 and 1992 were analyzed.

Results

An analysis of randomized, placebo-controlled, clinical trials showed that magnesium sulfate is not better than placebo in the treatment of premature labor. beta-Adrenergic receptor agonists effectively stop premature labor for only 24 to 48 hours. Calcium channel blockers and oxytocin antagonists inhibit uterine contractions, but their role in stopping labor is undefined. Prostaglandin inhibitors appear to be effective in treating premature labor and have few adverse side effects.

Conclusions

The only tocolytic drugs that might be effective are the prostaglandin inhibitors. Tocolytic agents should be used only between 24 and 32 completed weeks of gestation. Magnesium sulfate should not be used to treat premature labor. Oxytocin antagonists should be used only in experimental clinical trials. Calcium channel blockers and beta-adrenergic receptor agonists inhibit uterine contractions but do not prolong gestation for longer than 48 hours.

Topics

Pregnancy > Preterm Birth > PreventionGeneral OB/GYN > Clinical Practice > Guidelines
tocolytic agents preterm labor review, magnesium sulfate preterm labor ineffective, beta agonists preterm birth prevention, prostaglandin inhibitors preterm labor, calcium channel blockers tocolysis, oxytocin antagonists premature labor, stopping preterm contractions effectiveness, tocolytic drug safety efficacy, preterm labor treatment comparison, premature labor management protocols

Cite this article

Higby, K., Xenakis, E. M., & Pauerstein, C. J. (1993). Do tocolytic agents stop preterm labor? A critical and comprehensive review of efficacy and safety. *American journal of obstetrics and gynecology*, *168*(4), 1247-56; discussion 1256-9. https://doi.org/10.1016/0002-9378(93)90376-t

Keywords

Adrenergic beta-Agonists, Calcium Channel Blockers, Female, Humans, Magnesium Sulfate, Obstetric Labor, Premature, Oxytocin, Pregnancy, Prostaglandin Antagonists, Randomized Controlled Trials As Topic, Tocolytic Agents

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