What is Tocolysis in pregnancy?

What is Tocolysis in pregnancy?

Introduction. Tocolysis is an obstetrical procedure carried out with the use of medications with the purpose of delaying the delivery of a fetus in women presenting preterm contractions. These medications are administered with the hope of decreasing fetal morbidity and mortality.

What is indomethacin used for in pregnancy?

Indomethacin is often prescribed to pregnant women presenting with preterm labor or shortened cervix, which places them at risk for preterm labor and delivery. Indomethacin has been used since the 1970s to prolong pregnancy by decreasing uterine contractions.

What is Tocolytic effect?

Tocolytics (also called anti-contraction medications or labor suppressants) are medications used to suppress premature labor (from Greek τόκος tókos, “childbirth”, and λύσις lúsis, “loosening”). Preterm birth accounts for 70% of neonatal deaths.

When should tocolysis be used?

Healthcare professionals (such as midwives and obstetricians) offer tocolysis as appropriate to women between 26+0 and 33+6 weeks of pregnancy who have intact membranes and are in suspected or diagnosed preterm labour.

What drugs are used for tocolysis?

Answer. The most common tocolytic agents used for the treatment of preterm labor are magnesium sulfate (MgSO4), indomethacin, and nifedipine.

Can indomethacin cause abortion?

Indomethacin, indicated not only for pain but also to postpone preterm labour, was found to be more strongly associated with spontaneous abortions than other NSAIDs and in addition the association disappears only when excluding exposure that occurred during the last 4 days before the abortion.

Can Indocin cause miscarriage?

In general, NSAID use in pregnancy does not increase the risk of miscarriage, research confirms. Indomethacin, however, is an outlier. Find out why. Non-steroidal anti-inflammatory drugs do not increase the risk of miscarriage, according to a recently published study.

How long does tocolytic last?

Tocolytics are medications used to delay delivery, sometimes for up to 48 hours.

When do you give tocolytic?

Tocolytic medications for preterm labor aren’t used before 24 weeks of pregnancy. In certain situations, your doctor may use it when you are at 23 weeks of pregnancy. Many doctors stop giving tocolytics after a woman has reached her 34th week of pregnancy, but some doctors begin tocolytics as late as 36 weeks.

When is betamethasone given in pregnancy?

A single course of betamethasone is recommended for pregnant women between 34 0/7 weeks and 36 6/7 weeks of gestation at risk of preterm birth within 7 days, and who have not received a previous course of antenatal corticosteroids.

What drug relaxes the uterus?

Doctors may try to stop or delay preterm labor by administering a medication called terbutaline (Brethine). Terbutaline is in a class of drugs called betamimetics. They help prevent and slow contractions of the uterus. It may help delay birth for several hours or days.

Is Indocin safe for pregnancy?

Women who are more than 32 weeks pregnant should avoid taking indomethacin, given the potential for heart problems in the baby. Women with a history of ulcers, bleeding disorders, or kidney or liver disease should also avoid taking indomethacin.

How long can tocolytics delay labor?

Tocolytics are medications used to delay delivery, sometimes for up to 48 hours. If delivery is delayed even a few hours, it may allow more time to give corticosteroids or magnesium sulfate. This delay also may allow time for transfer to a hospital with specialized care for preterm babies.

What is the best tocolytic?

Prostaglandin inhibitors and calcium channel blockers were the tocolytics with the best probability of being ranked in the top three medication classes for the outcomes of 48 hour delay in delivery, respiratory distress syndrome, neonatal mortality, and maternal side effects (all cause).