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Tocolytics are used in preterm labor, which refers to when a baby is born too early before 37 weeks of pregnancy. As preterm birth represents one of the leading causes of neonatal morbidity and mortality, the goal is to prevent neonatal morbidity and mortality through delaying delivery and increasing gestational age by gaining more time for other management strategies like corticosteroids ...
In a 2010 meta-analysis, [10] nifedipine is superior to β 2 adrenergic receptor agonists and magnesium sulfate for tocolysis in women with preterm labor (20–36 weeks), but it has been assigned to pregnancy category C by the U.S. Food and Drug Administration, so is not recommended before 20 weeks, or in the first trimester. [9]
Ritodrine, sold under the brand name Yutopar, is a tocolytic drug used to stop premature labor. [2] [3] This drug has been removed from the US market, according to FDA Orange Book. It was available in oral tablets or as an injection and was typically used as the hydrochloride salt. The drug acts as a selective β 2-adrenergic receptor agonist. [4]
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The tocolytic agent atosiban (Tractocile) acts as an antagonist of oxytocin receptors. It is registered in many countries for use in suppressing premature labor between 24 and 33 weeks of gestation. It has fewer side effects than drugs previously used for this purpose (such as ritodrine, salbutamol and terbutaline). [11]
It should not be used to prevent preterm labor or delay labor more than 48–72 hours. In February 2011, the Food and Drug Administration began requiring a black box warning on the drug's label. Pregnant women should not be given injections of the drug terbutaline for the prevention of preterm labor or for long-term (beyond 48–72 hours ...
If it occurs before 37 weeks it is known as PPROM (preterm prelabor rupture of membranes) otherwise it is known as term PROM. [2] Treatment is based on how far along a woman is in pregnancy and whether complications are present. [2] In those at or near term without any complications, induction of labor is generally recommended. [2]
Use of tocolytics (medications to suppress labor) have been proposed, usually done in addition to bladder filling rather than as a stand-alone intervention. [ 13 ] If the mother is far from delivery, funic reduction (manually placing the cord back into the uterine cavity) has been attempted, [ 14 ] with successful cases reported. [ 15 ]