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Tocolytic

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41. The influence of tocolytic drugs on cardiac function, large arteries, and resistance vessels. Full Text available with Trip Pro

The influence of tocolytic drugs on cardiac function, large arteries, and resistance vessels. Beta-2 adrenoceptor agonistic drugs like ritodrine have been the reference tocolytic drugs, but are associated with cardiovascular side-effects. Atosiban, a newer drug, is a competitive antagonist of oxytocin and has been claimed to have fewer cardiovascular side effects. Until now, there has mainly been a subjective reporting of adverse reactions and few objective cardiovascular data. Evaluation

2011 European journal of clinical pharmacology Controlled trial quality: uncertain

42. Different effects of tocolytic medication on blood pressure and blood pressure amplification. Full Text available with Trip Pro

Different effects of tocolytic medication on blood pressure and blood pressure amplification. The importance of tocolysis has been discussed extensively. Beta-2 adrenoceptor agonistic drugs like ritodrine have been the reference tocolytic drugs in most countries. Cardiovascular side-effects are frequent. Atosiban, a newer tocolytic drug, is a competitive antagonist of oxytocin and has fewer cardiovascular side effects. Although large studies exist, there is mainly subjective reporting

2011 European journal of clinical pharmacology Controlled trial quality: uncertain

43. Magnesium sulfate as a second-line tocolytic agent for preterm labor: a randomized controlled trial in kyushu island. Full Text available with Trip Pro

Magnesium sulfate as a second-line tocolytic agent for preterm labor: a randomized controlled trial in kyushu island. We evaluated the efficacy of magnesium sulfate as a second-line tocolysis for 48  hours.A multi-institutional, simple 2-arm randomized controlled trial was performed. Forty-five women at 22 to 34 weeks of gestation were eligible, whose ritodrine did not sufficiently inhibit uterine contractions. After excluding 12 women, 33 were randomly assigned to either magnesium alone

2011 Journal of pregnancy Controlled trial quality: uncertain

44. Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study. Full Text available with Trip Pro

Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study. To evaluate the incidence of serious maternal complications after the use of various tocolytic drugs for the treatment of preterm labour in routine clinical situations.Prospective cohort study.28 hospitals in the Netherlands and Belgium.1920 consecutive women treated with tocolytics for threatened preterm labour.Maternal adverse events (those suspected of being causally related to treatment were (...) considered adverse drug reactions) leading to cessation of treatment.An independent panel evaluated the recorded adverse events, without knowledge of the type of tocolytic used. Of the 1920 women treated with tocolytics, 1327 received a single course of treatment (69.1%), 282 sequential courses (14.7%), and 311 combined courses (16.2%). Adverse drug reactions were categorised as serious or mild in 14 cases each. The overall incidence of serious adverse drug reaction was 0.7%. Compared with atosiban

2009 BMJ

45. Twin and triplet pregnancy

with a twin or triplet pregnancy: arabin pessary bed rest cervical cerclage oral tocolytics. [2019] [2019] T o find out why the committee made the 2019 recommendations on preventing preterm birth (and why they did not make a recommendation on vaginal progesterone) and how they might affect practice, see rationale and impact. Corticosteroids Corticosteroids 1.5.3 Inform women with a twin or triplet pregnancy of their increased risk of preterm birth (see recommendation 1.4.13) and about the benefits

2019 National Institute for Health and Clinical Excellence - Clinical Guidelines

47. Biomarker tests to help diagnose preterm labour in women with intact membranes

#notice-of-rights). Page 21 of 36Costs Costs 4.30 The following costs, from companies, published literature and routine sources of NHS costs, were used in the model: fetal fibronectin test: £66 (includes 15 minutes of midwife time) Actim Partus test: £35 (includes 10 minutes of midwife time) PartoSure test: £52 (includes 10 minutes of midwife time) maternal steroid injection: £5 tocolytics (atosiban plus infusion equipment): £362 inpatient hospital stay: £1,325 in utero transfer: £965 long-term

2018 National Institute for Health and Clinical Excellence - Diagnostics Guidance

48. Care of Women Presenting with Suspected Preterm Prelabour Rupture of Membranes from 24+0 Weeks of Gestation Full Text available with Trip Pro

looking for the following terms in the title or abstract ‘preterm prelabour rupture of membranes’, ‘amnioinfusion’, ‘chorioamnionitis,’ ‘intra‐amniotic infection’, ‘IGFBP‐1’, ‘PAMG‐1’, ‘amniocentesis’, ‘antenatal corticosteroids’ and ‘tocolytics’. The search was restricted to articles published until January 2019. The full search strategy is available to view online as supporting information (Appendix and ). This guideline was developed using the methodology described in Clinical Governance Advice 1 (...) +0 weeks of gestation. Evidence level 1++ The neuroprotective effect of magnesium sulfate in women with PPROM has been demonstrated in a cohort study. Evidence level 2++ The RCOG and NG25 recommend offering magnesium sulfate to women at risk of giving birth before 30 +0 weeks of gestation. NG25 recommends that magnesium sulfate should be considered when preterm birth is anticipated between 30 +0 and 33 +6 weeks. Evidence level 4 6.4 Should tocolytic agents be used? Recommendation Evidence Level

2019 Royal College of Obstetricians and Gynaecologists

49. Clinical Guideline: Perinatal care of suspected or confirmed COVID-19 in pregnant women

in first or second trimester 41 o In the setting of maternal fever in general, there is mixed data about the risk of congenital abnormalities during embryogenesis 42-45 Threatened preterm labour • No current evidence sufficient to alter usual indications/recommendations for: o Antenatal corticosteroids o Magnesium sulfate o Tocolytics Queensland Clinical Guideline: Maternity care for mothers and babies during the COVID-19 pandemic Refer to online version, destroy printed copies after use Page 16 of 29

2020 Queensland Health

51. Premature labour

. Combining cervical ultrasound and fetal fibronectin gives the best prediction of progression to preterm birth. Effective prophylactic interventions have not been identified. Cervical cerclage has a limited role in high-risk women, and progesterone therapy may be of benefit. Few lifestyle interventions improve outcome, but cessation of smoking is recommended. In utero transfer to appropriate neonatal facilities and antenatal corticosteroids reduce perinatal mortality and morbidity. Tocolytic agents

2018 BMJ Best Practice

53. Placenta Praevia and Placenta Accreta: Diagnosis and Management Full Text available with Trip Pro

of gestation indicated that corticosteroids administration at 35 +5 weeks of gestation followed by planned delivery at 36 weeks of gestation optimises maternal and neonatal outcomes. 69 Evidence level 4 4.7 Is there a place for the use of tocolytics in women presenting with symptomatic low‐lying placenta or placenta praevia, who are in suspected preterm labour? Tocolysis for women presenting with symptomatic placenta praevia or a low‐lying placenta may be considered for 48 hours to facilitate (...) administration of antenatal corticosteroids. [ New 2018 ] Grade of recommendation: C If delivery is indicated based on maternal or fetal concerns, tocolysis should not be used in an attempt to prolong gestation. [ New 2018 ] Grade of recommendation: C A systematic review to determine if the prolonged (48 hours or more) use of tocolytics in women with symptomatic preterm placenta praevia improves perinatal outcome identified two retrospective studies (total, n = 217) and one RCT (n = 60). The results

2018 Royal College of Obstetricians and Gynaecologists

54. Nifedipine

. But if you still have questions please contact us via jon.brassey@tripdatabase.com Top results for nifedipine 1. Nifedipine in the management of preterm labor: a systematic review and metaanalysis Nifedipine in the management of preterm labor: a systematic review and metaanalysis Nifedipine in the management of preterm labor: a systematic review and metaanalysis Conde-Agudelo A, Romero R, Kusanovic JP CRD summary The review concluded that nifedipine appeared to be a more effective tocolytic agent than (...) beta 2 -adrenergic-receptor agonists and better tolerated compared with beta 2 -adrenergic-receptor (...) agonists and magnesium sulfate in women with preterm labour. The review was generally well conducted, but the authors’ conclusions regarding magnesium sulphate may be too strong given the small number of trials included in the analyses. Authors' objectives To determine the efficacy and safety of nifedipine as a tocolytic agent in women with preterm labour. Searching MEDLINE, EMBASE, LILACS, Web

2018 Trip Latest and Greatest

56. Preterm fetal monitoring

Gynecol Scand 1999;78: 493-500. 21. Verdurmen, K. M. J., Hulsenboom, A. D. J., van Laar, J. O. E. H. & Oei, S. G. Effect of tocolytic drugs on fetal heart rate variability: a systematic review. J. Matern. Fetal. Neonatal Med. 30, 2387–2394 (2017). 22. de Heus, R. et al. Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study. BMJ 338, b744 (2009). 23. Grandi, G. et al. Vaginal alpha-lipoic acid shows an anti-inflammatory effect on the cervix, preventing its (...) shortening after primary tocolysis. A pilot, randomized, placebo- controlled study. J. Matern. Fetal. Neonatal Med. 30, 2243–2249 (2017). 24. Neri, I. et al. Computerized evaluation of fetal heart rate during tocolytic treatment: comparison between atosiban and ritodrine. Am. J. Perinatol. 26, 259–263 (2009). 25. Hallak, M. et al. The effect of magnesium sulfate on fetal heart rate parameters: A randomized, placebo-controlled trial. Am. J. Obstet. Gynecol. 181, 1122–1127 (1999). 26. Nensi et al. E ect

2019 Nordic Federation of Societies of Obstetrics and Gynecology

57. Magnesium sulfate: risk of skeletal adverse effects in the neonate following prolonged or repeated use in pregnancy

–7 days when used as a tocolytic (not an authorised indication in the UK). Such prolonged exposure may result in significantly higher cumulative doses than those encountered with use of magnesium sulfate in the UK for eclampsia or foetal neuroprotection (see ). The US FDA alert was based on 4 reports of fractures and 35 reports of osteopenia or radiographical bone abnormalities in neonates, some of which also describe hypocalcaemia and hypermagnesemia in the neonate. The long-term clinical

2019 MHRA Drug Safety Update

60. Low-Dose Aspirin Use During Pregnancy

growth retardation. Br J Obstet Gynaecol 1997;104:450–9. 47. Abramovici A, Cantu J, Jenkins SM. Tocolytic therapy for acute preterm labor. Obstet Gynecol Clin North Am 2012; 39:77–87. 48. van Vliet EO, Askie LA, Mol BW, Oudijk MA. Antiplatelet agents and the prevention of spontaneous preterm birth: a systematic review and meta-analysis. Obstet Gynecol 2017;129:327–36. 49. Silver RM, Ahrens K, Wong LF, Perkins NJ, Galai N, LesherLL,et al.Low-doseaspirin and pretermbirth: aran- domized controlled trial

2018 American College of Obstetricians and Gynecologists

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