Acute tocolysis for uterine activity reduction in term labor: a review.

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de Heus R, Mulder EJ, Derks JB, Visser GH

Acute tocolysis for uterine activity reduction in term labor: a review.

Obstet Gynecol Surv. 2008 Jun;63(6):383-8; quiz 405. doi: 10.1097/OGX.0b013e31816ff75b.

PubMed ID

18492294 [ View in PubMed

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Abstract

This review critically evaluates the efficacy of different tocolytics in reducing uterine pressure and contractions in term labor. The available evidence supports the use of beta-adrenergic-receptor agonists such as terbutaline or ritodrine; they appear to have an immediate and comparable profound effect on uterine activity in term labor. However, the preferred type of beta-adrenergic receptor agonist and dosage are unclear. The oxytocin receptor antagonist atosiban has a high specificity for the uterus with limited or no systemic effects and could therefore be an attractive alternative for use in term labor. The evidence on the tocolytic potency of a single bolus of atosiban for tocolysis in term labor is encouraging but limited and needs further research. Moreover, atosiban lacks United States Food and Drug Administration approval. Literature documenting efficacy and safety of nitroglycerin or magnesium sulfate in term labor is far from convincing. The theoretical basis for the use of tocolytics for nonreassuring intrapartum fetal heart rate patterns is to reduce the aggravating influence of uterine contractions. However, the clinical evidence that tocolytics in term active labor are actually beneficial in improving neonatal outcome is very limited.

DrugBank Data that Cites this Article

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Atosiban	Oxytocin receptor	Protein	Humans	Yes	Antagonist	Details
Ritodrine	Beta adrenergic receptor (Protein Group)	Protein group	Humans	Yes	Agonist Downregulator	Details