Maintenance tocolysis: a reappraisal of clinical evidence

Stelzl P, Kehl S, Rath W (2019)

Publication Type: Journal article, Review article

Publication year: 2019

Journal

Archives of Gynecology and Obstetrics Springer

Book Volume: 300

Pages Range: 1189-1199

Journal Issue: 5

DOI: 10.1007/s00404-019-05313-7

Abstract

Introduction: Maintenance tocolysis, mostly defined as the continuation of tocolytic treatment beyond 48 h, remains a matter of debate. There is no sufficient evidence from randomized controlled trials, that maintenance tocolysis is able to prolong pregnancy significantly and to reduce severe neonatal morbidity and mortality. Hence, it is not recommended in current guidelines. On the contrary, maintenance tocolysis is commonly used in clinical practice and subject of current clinical-scientific investigations. Tocolytics for maintenance treatment: None of the conventional tocolytics (beta-sympathomimetics, calcium-channel blockers, magnesium, cyclooxygenase inhibitors, and oxytocin receptor antagonists) have proven to be appropriate for maintenance treatment. Progesterone and 17-α-hydroxyprogesterone caproate have shown promising results in low-quality randomized trials, but not in high-quality studies. Discussion: Basically, the value of studies regarding maintenance tocolysis is limited by a considerable heterogeneity, its mostly low quality, significant differences in methodology as well as the inadequate statistical power due to the small number of women studied. So far, maintenance tocolysis is a case-by-case decision outweighing the benefits and harms of tocolytic treatment.

Authors with CRIS profile

Patrick Stelzl Lehrstuhl für Geburtshilfe und Frauenheilkunde Sven Kehl Department of Obstetrics and Gynaecology

Involved external institutions

Universitätsklinikum Schleswig-Holstein (UKSH) DE Germany (DE)

How to cite

APA:

Stelzl, P., Kehl, S., & Rath, W. (2019). Maintenance tocolysis: a reappraisal of clinical evidence. Archives of Gynecology and Obstetrics, 300(5), 1189-1199. https://doi.org/10.1007/s00404-019-05313-7

MLA:

Stelzl, Patrick, Sven Kehl, and Werner Rath. "Maintenance tocolysis: a reappraisal of clinical evidence." Archives of Gynecology and Obstetrics 300.5 (2019): 1189-1199.

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