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By Chad Klauser Maternal Fetal Medicine physician in NYC
Caroline A Crowther, Julie Brown, Christopher J D McKinlay, Philippa Middleton
BACKGROUND: Magnesium sulphate has been used in some settings as a tocolytic agent to inhibit uterine activity in women in preterm labour with the aim of preventing preterm birth. OBJECTIVES: To assess the effects of magnesium sulphate therapy given to women in threatened preterm labour with the aim of preventing preterm birth and its sequelae. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (last searched 31 January 2014)...
2014: Cochrane Database of Systematic Reviews
Kjell Haram, Jan Helge Seglem Mortensen, John C Morrison
The central rationale of tocolysis for preterm labor (PTL) is to delay delivery for at least 48 h to allow for transfer of the mother to a tertiary facility and for corticosteroids to induce surfactant production in fetal lungs. Beta-mimetics decrease the number of women in preterm labor giving birth within 48 h without reducing adverse neonatal outcomes. Calcium channel blockers inclusive of nifedipine decrease the adverse neonatal outcomes by significantly delaying delivery. Atosiban has the best maternal and fetal safety profile but does not seem to reduce neonatal complications...
March 2015: Journal of Maternal-fetal & Neonatal Medicine
Joshua P Vogel, Juan Manuel Nardin, Therese Dowswell, Helen M West, Olufemi T Oladapo
BACKGROUND: Preterm birth represents the single largest cause of mortality and morbidity for newborns and a major cause of morbidity for pregnant women. Tocolytic agents include a wide range of drugs that can inhibit labour to prolong pregnancy. This may gain time to allow the fetus to mature further before being born, permit antenatal corticosteroid administration for lung maturation, and allow time for intra-uterine transfer to a hospital with neonatal intensive care facilities. However, some tocolytic drugs are associated with severe side effects...
2014: Cochrane Database of Systematic Reviews
Carolien Roos, Marc E A Spaanderman, Ewoud Schuit, Kitty W M Bloemenkamp, Antoinette C Bolte, Jérôme Cornette, Johannes J J Duvekot, Jim van Eyck, Maureen T M Franssen, Christianne J de Groot, Joke H Kok, Anneke Kwee, Ashley Merién, Bas Nij Bijvank, Brent C Opmeer, Martijn A Oudijk, Mariëlle G van Pampus, Dimitri N M Papatsonis, Martina M Porath, Hubertina C J Scheepers, Sicco A Scherjon, Krystyna M Sollie, Sylvia M C Vijgen, Christine Willekes, Ben Willem J Mol, Joris A M van der Post, Fred K Lotgering
IMPORTANCE: In threatened preterm labor, maintenance tocolysis with nifedipine, after an initial course of tocolysis and corticosteroids for 48 hours, may improve perinatal outcome. OBJECTIVE: To determine whether maintenance tocolysis with nifedipine will reduce adverse perinatal outcomes due to premature birth. DESIGN, SETTING, AND PARTICIPANTS: APOSTEL-II (Assessment of Perinatal Outcome with Sustained Tocolysis in Early Labor) is a double-blind, placebo-controlled trial performed in 11 perinatal units including all tertiary centers in The Netherlands...
January 2, 2013: JAMA: the Journal of the American Medical Association
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