Tocolysis in preterm labor: Always safe?

Pantazis K, Asimakopoulos E, Bontis JN

1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, Greece

Correspondence: Pantazis Konstantinos, 199 Vasilissis Olgas Avenue, GR-54646 Thessaloniki, Greece. E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

 


 

Abstract

Preterm labor is the most important single determinant affecting neonatal mortality and morbidity, as well as quality of life. Although large progress has been seen in neonatal care, little has been achieved so far in the treatment of preterm labor, despite of the large number of treatments that have been tried. The traditional use of tocolysis has not been shown to improve neonatal outcome apart from two occasions: when, in a gestation smaller than 34 weeks, time is gained to allow for a full course of corticosteroids, in order to enhance lung maturation, and when there is need for in-utero transfer to a hospital that can provide neonatal intensive care. In all other cases tocolysis either fails to prolong the pregnancy or the fetal/maternal adverse effects counteract the gain from delaying labour. There is need for tissue specific tocolytics that will provide higher efficacy with fewer side effects. Oxytocin-antagonist Atosiban, which is the newest of currently available tocolytics, is a clear step forward, although the proven advantages appear to be defined to safety but not efficacy so far.

Key words: preterm labor; tocolysis; tocolysis contraindications; tocolytics’ adverse effects; prematurity