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Maintenance Tocolytic Therapy

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Preterm Labor and Delivery

Part of the book series: Comprehensive Gynecology and Obstetrics ((CGO))

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Abstract

Several drugs have been developed to reduce the likelihood of preterm delivery even though its efficacy lasts <48 h. Each tocolytic agent has side effects and evidence of limited efficacy, therefore is not suitable for long-term usage. Maintenance therapy with nifedipine, ritodrine, terbutaline, or magnesium sulfate has been assessed, resulting in neither improved perinatal outcome nor pregnancy prolongation. It is conceivable that it may be beneficial to use maintenance therapy in selected cases of very preterm birth, where fetal compromise and intrauterine infection have been ruled out.

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References

  1. Han S, Crowther CA, Moore V. Magnesium maintenance therapy for preventing preterm birth after threatened preterm labour. Cochrane Database Syst Rev. 2013;(5):CD000940. https://doi.org/10.1002/14651858.CD000940.pub3.

  2. Dodd JM, Crowther CA, Middleton P. Oral betamimetics for maintenance therapy after threatened preterm labour oral betamimetics for maintenance therapy after threatened preterm labour. Cochrane Database Syst Rev. 2012;(12):CD003927. https://doi.org/10.1002/14651858.CD003927.pub3.

  3. Chawanpaiboon S, Laopaiboon M, Lumbiganon P, Sangkomkamhang US, Dowswell T. Terbutaline pump maintenance therapy after threatened preterm labour for reducing adverse neonatal outcomes. Cochrane Database Syst Rev. 2014;(3):CD010800. https://doi.org/10.1002/14651858.CD010800.pub2.

  4. van Vliet E, Dijkema GH, Schuit E, Heida KY, Roos C, van der Post J, et al. Nifedipine maintenance tocolysis and perinatal outcome: an individual participant data meta-analysis. BJOG. 2016;123:1753.

    Article  Google Scholar 

  5. U.S. Food and Drug Administration. FDA drug safety communication: FDA recommends against prolonged use of magnesium sulfate to stop pre-term labor due to bone changes in exposed babies. 2013 May 30. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-fda-recommends-against-prolonged-use-magnesium-sulfate-stop-pre-term. Accessed 2 May 2019.

  6. Neilson JP, West HM, Dowswell T. Betamimetics for inhibiting preterm labour (review). Cochrane Database Syst Rev. 2014;(2):CD004352. https://doi.org/10.1002/14651858.CD004352.pub3.

  7. U.S. Food and Drug Administration. FDA drug safety communication: new warnings against use of terbutaline to treat preterm labor. https://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communication-new-warnings-against-use-terbutaline-treat-preterm-labor. Accessed 2 May 2019.

  8. Kawagoe Y, Sameshima H, Ikenoue T. Evaluation of the efficacy of long-term tocolysis for prolongation of pregnancy. J Jpn Soc Perin Neon Med. 2009;45(4):1048–50.

    Google Scholar 

  9. Kawagoe Y, Sameshima H, Ikenoue T, Yasuhi I, Kawarabayashi T. Magnesium sulfate as a second-line tocolytic agent for preterm labor: a randomized controlled trial in Kyushu Island. J Pregnancy. 2011;2011:965060. https://doi.org/10.1155/2011/965060.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Romero R, Sibai BM, Sanchez-Ramos L, Valenzuela GJ, Veille JC, Tabor B, et al. An oxytocin receptor antagonist (atosiban) in the treatment of preterm labor: a randomized, double-blind, placebo-controlled trial with tocolytic rescue. Am J Obstet Gynecol. 2000;182(5):1173–83.

    Article  CAS  Google Scholar 

  11. Flenady V, Reinebrant HE, Liley HG, Tambimuttu EG, Papatsonis DN. Oxytocin receptor antagonists for inhibiting preterm labour. Cochrane Database Syst Rev. 2014;(6):CD004452. https://doi.org/10.1002/14651858.CD004452.pub3.

  12. Valenzuela G, Sanchez-Ramos L, Romero R, Silver HM, Koltun WD, Millar L, et al. Maintenance treatment of preterm labor with the oxytocin antagonist atosiban. The atosiban PTL-098 Study Group. Am J Obstet Gynecol. 2000;182:1184–90.

    Article  CAS  Google Scholar 

  13. Papatsonis DNM, Flenady V, Liley HG. Maintenance therapy with oxytocin antagonists for inhibiting preterm birth after threatened preterm labour. Cochrane Database Syst Rev. 2013;(10):CD005938. https://doi.org/10.1002/14651858.CD005938.pub3.

  14. Flenady V, Wojcieszek AM, Papatsonis DN, Stock OM, Murray L, Jardine LA, et al. Calcium channel blockers for inhibiting preterm labour and birth. Cochrane Database Syst Rev. 2014;(6):CD002255. https://doi.org/10.1002/14651858.CD002255.pub2.

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Correspondence to Yasuyuki Kawagoe M.D., Ph.D. .

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Kawagoe, Y. (2020). Maintenance Tocolytic Therapy. In: Sameshima, H. (eds) Preterm Labor and Delivery. Comprehensive Gynecology and Obstetrics. Springer, Singapore. https://doi.org/10.1007/978-981-13-9875-9_12

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  • DOI: https://doi.org/10.1007/978-981-13-9875-9_12

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-13-9874-2

  • Online ISBN: 978-981-13-9875-9

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