Document Detail


Acute tocolysis for uterine activity reduction in term labor: a review.
MedLine Citation:
PMID:  18492294     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Roel de Heus; Eduard J H Mulder; Jan B Derks; Gerard H A Visser
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Obstetrical & gynecological survey     Volume:  63     ISSN:  0029-7828     ISO Abbreviation:  Obstet Gynecol Surv     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-21     Completed Date:  2008-10-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401007     Medline TA:  Obstet Gynecol Surv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  383-8; quiz 405     Citation Subset:  IM    
Affiliation:
Department of Perinatology and Gynecology, University Medical Centre Utrecht, The Netherlands. roeldeheus@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Agonists / administration & dosage*
Female
Humans
Labor, Obstetric / drug effects*,  physiology
Nitric Oxide / metabolism
Nitroglycerin / administration & dosage
Pregnancy
Ritodrine / administration & dosage*
Terbutaline / administration & dosage
Tocolytic Agents / administration & dosage*
Uterine Contraction / drug effects*
Vasotocin / administration & dosage,  analogs & derivatives
Chemical
Reg. No./Substance:
0/Adrenergic beta-Agonists; 0/Tocolytic Agents; 10102-43-9/Nitric Oxide; 23031-25-6/Terbutaline; 26652-09-5/Ritodrine; 55-63-0/Nitroglycerin; 9034-50-8/Vasotocin; 90779-69-4/atosiban

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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