Premedical Student.
Resident.
Obstet Gynecol Surv. 2019 Jan;74(1):50-55. doi: 10.1097/OGX.0000000000000635.
Preterm delivery represents an important cause of infant morbidity and mortality. Various tocolytics have been studied with the objective of stopping preterm labor, increasing gestational age at delivery, and preventing complications related to preterm birth.
This review aims to summarize the major classes of tocolytics and review the evidence regarding use of each.
A PubMed search of the following terms was performed to gather relevant data: "tocolytic," "preterm labor," "preterm delivery," "PPROM," "magnesium," "indomethacin," "nifedipine," and "betamimetics."
The benefits and risks of nonsteroid anti-inflammatory drugs, calcium channel blockers, magnesium, and betamimetics are reviewed. Calcium channel blockers afford superior outcomes in terms of prolonging gestation and decreasing neonatal morbidity and mortality with the fewest adverse effects.
Tocolytics, particularly calcium channel blockers, may provide benefit to pregnant women and their infants. Their use should be tailored to the particular clinical circumstances of the patient and used in conjunction with other management strategies (, administration of corticosteroids for fetal lung maturation or magnesium for neuroprotection and transfer to a tertiary medical center). Further research and professional guidelines are needed on optimal use of these agents.
早产是婴儿发病率和死亡率的重要原因。已经研究了各种保胎药物，以达到停止早产、延长分娩时的胎龄和预防与早产相关的并发症的目的。
本综述旨在总结主要的保胎药物类别，并综述每种药物的使用证据。
通过在 PubMed 上搜索以下术语来收集相关数据：“保胎药”、“早产”、“早产分娩”、“胎膜早破”、“镁”、“吲哚美辛”、“硝苯地平”和“β拟交感神经药”。
综述了非甾体类抗炎药、钙通道阻滞剂、镁和β拟交感神经药的益处和风险。钙通道阻滞剂在延长胎龄、降低新生儿发病率和死亡率方面具有最佳效果，且不良反应最少。
保胎药，特别是钙通道阻滞剂，可能对孕妇及其婴儿有益。它们的使用应根据患者的具体临床情况进行调整，并与其他管理策略（例如为胎儿肺成熟而给予皮质类固醇，或为神经保护和转移到三级医疗中心而给予镁）结合使用。需要进一步研究和制定关于这些药物最佳使用的专业指南。
