The efficacy and safety of various tocolytics for preterm labor


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Abstract

The prevention and treatment of preterm labor remain an unsolved problem in modern obstetrics. Certain successes have been currently achieved in the treatment of threatened preterm labor due to drugs that suppress uterine contractile activity, which include tocolytics. The most widely used tocolytic agents are ß-adrenomimetics; however, they are associated with a high frequency of unpleasant and sometimes severe maternal side effects. Calcium channel blockers may have similar tocolytic efficacy with fewer side effects than ß-adrenomimetics. Oxytocin receptor antagonists also have a low side effect profile. The administration of tocolytic drugs can reduce the strength and frequency of uterine contractions, delay the onset of labor for 48 hours and/or even 7 days, but cannot prolong pregnancy to full-term. The drugs are administered within 48 hours in order to prevent fetal respiratory distress syndrome, to perform magnesium sulfate therapy for fetal neuroprotection, and to transfer a pregnant woman to a Group III hospital. Currently, the choice of a drug for tocolysis remains debatable. Conclusion. It is necessary to continue clinical trials in order to select an effective, and most importantly safe, therapy for threatened preterm labor.

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About the authors

Natalya V. Artymuk

Kemerovo State Medical University, Ministry of Health of Russia

Email: artymuk@gmail.com
MD, PhD, Professor, Head of the G.A. Ushakova Department of Obstetrics and Gynecology Kemerovo, Russia

Kristina V. Marochko

Kemerovo State Medical University, Ministry of Health of Russia

Email: marochkokv@mail.ru
PhD, assistant of the G.A. Ushakova Department of Obstetrics and Gynecology Kemerovo, Russia

Elizaveta A. Chvanova

S.V. Belyaev Kuzbass Regional Clinical Hospital

Email: cherish001@mail.ru
obstetrician-gynecologist of the Perinatal center Kemerovo, Russia

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