Maintaining and repeating tocolysis: A reflection on evidence

Isabelle Dehaene, Lina Bergman, Paula Turtiainen, Alexandra Ridout, Ben Willem Mol, Elsa Lorthe, from the International Spontaneous Preterm birth Young Investigators group (I-SPY)

Research output: Contribution to journalReview ArticleResearchpeer-review

5 Citations (Scopus)

Abstract

It is inherent to human logic that both doctors and patients want to suppress uterine contractions when a woman presents in threatened preterm labor. Tocolysis is widely applied in women with threatened preterm labor with a variety of drugs. According to literature, tocolysis is indicated to enable transfer to a tertiary center as well as to ensure the administration of corticosteroids for fetal maturation. There is international discrepancy in the content and the implementation of guidelines on preterm labor. Tocolysis is often maintained or repeated. Nevertheless, the benefit of prolonging pregnancy has not yet been proven, and it is not impossible that prolongation of the pregnancy in a potential hostile environment could harm the fetus. Here we reflect on the use of tocolysis, focusing on maintenance and repeated tocolysis, and compare international guidelines and practices to available evidence. Finally, we propose strategies to improve the evaluation and use of tocolytics, with potential implications for future research.

Original languageEnglish
Pages (from-to)468-476
Number of pages9
JournalSeminars in Perinatology
Volume41
Issue number8
DOIs
Publication statusPublished - 1 Dec 2017
Externally publishedYes

Keywords

  • I-SPY
  • Maintenance tocolysis
  • Preterm birth
  • Preterm labor
  • Repeated tocolysis
  • Tocolysis

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