Acute Tocolysis - a Critical Analysis of Evidence-Based Data

Rath W, Kehl S (2018)

Publication Type: Journal article

Publication year: 2018

Journal

Geburtshilfe und Frauenheilkunde Georg Thieme Verlag

Book Volume: 78

Pages Range: 1245-1255

Journal Issue: 12

DOI: 10.1055/a-0717-5329

Abstract

Tocolysis is among the most common obstetric measures. The objective is to prolong the pregnancy by at least 48 hours to complete foetal lung maturation and for the in-utero transfer of the pregnant woman to a perinatal centre. The indication for tocolysis is regular, premature contractions (≥ 4/20 min) and a dynamic shortening of the cervical length/cervical opening between 22 + 0 to 33 + 6 weeks of pregnancy. In this connection, the cervical length measured on ultrasound and the determination of biomarkers in the cervicovaginal secretions can be important decision-making aids. Beta sympathomimetics should no longer be used due to the high rate of severe maternal adverse effects. Given controversial data, magnesium sulphate is no longer recommended for tocolysis in current guidelines. Atosiban is as effective for prolonging pregnancy as beta sympathomimetics and nifedipine, has the lowest rate of maternal adverse effects, but also the highest drug costs. Nifedipine and indomethacin are recommended in international guidelines for acute tocolysis, however there are indications of increased neonatal morbidity following indomethacin. Current problems are, above all, the lack of randomised, controlled comparative and placebo-controlled studies, the data which are controversial to some extent, and the insufficient evidence of tocolytics to significantly improve the neonatal outcome.

Authors with CRIS profile

Sven Kehl Department of Obstetrics and Gynaecology

Involved external institutions

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

How to cite

APA:

Rath, W., & Kehl, S. (2018). Acute Tocolysis - a Critical Analysis of Evidence-Based Data. Geburtshilfe und Frauenheilkunde, 78(12), 1245-1255. https://doi.org/10.1055/a-0717-5329

MLA:

Rath, Werner, and Sven Kehl. "Acute Tocolysis - a Critical Analysis of Evidence-Based Data." Geburtshilfe und Frauenheilkunde 78.12 (2018): 1245-1255.

BibTeX: Download