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Tocolytic

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41. Network meta-analysis shows that prostaglandin inhibitors and nifedipine are best short-term tocolytics for preterm delivery. (PubMed)

Network meta-analysis shows that prostaglandin inhibitors and nifedipine are best short-term tocolytics for preterm delivery. 23386705 2014 06 02 2018 12 02 1473-6810 18 5 2013 Oct Evidence-based medicine Evid Based Med Network meta-analysis shows that prostaglandin inhibitors and nifedipine are best short-term tocolytics for preterm delivery. 182-3 10.1136/eb-2012-101128 Abramovici Adi A Department of Obstetrics & Gynecology, University of Alabama, , Birmingham, Alabama, USA. Jenkins Sheri S (...) eng Journal Article Comment 2013 02 05 England Evid Based Med 9608386 1356-5524 0 Tocolytic Agents IM BMJ. 2012;345:e6226 23048010 Female Humans Obstetric Labor, Premature prevention & control Pregnancy Tocolysis methods Tocolytic Agents therapeutic use 2013 2 7 6 0 2013 2 7 6 0 2014 6 3 6 0 ppublish 23386705 eb-2012-101128 10.1136/eb-2012-101128

2013 Evidence-based medicine

42. Tocolytic indomethacin: effects on neonatal haemodynamics and cerebral autoregulation in the preterm newborn. (PubMed)

Tocolytic indomethacin: effects on neonatal haemodynamics and cerebral autoregulation in the preterm newborn. Indomethacin has vasoactive properties in cerebral and systemic vascular beds, and it improves cerebral autoregulatory ability. We speculated that tocolytic indomethacin will improve cerebral autoregulatory ability in the very preterm infant in early postnatal life.Eighteen stable preterm infants gestational age (GA) 25.3-29.6 weeks, birth weight (BW) 660-1430 grams), whose mothers had (...) received 50-150 mg of tocolytic indomethacin within 24 h before birth, and 18 individually matched controls (GA 25.0-29.7 weeks, BW 700-1390 grams) were studied four times for 15 min in the first 24 h of life. Autoregulation was assessed by determining correlations between mean arterial blood pressure (MABP (mm Hg)) and near-infrared spectroscopy-monitored cerebral oxygenation (rScO2).MABPs were significantly higher in the indomethacin infants than in the control infants (p=0.03). A decreased ability

2013 Archives of Disease in Childhood. Fetal and Neonatal Edition

43. Tocolytic

Tocolytic Tocolytic Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Tocolytic Tocolytic Aka: Tocolytic , Tocolysis II. Indications III (...) . Contraindications (See specific medications) or lethal fetal anomaly <100 >180 or Maternal bleeding with hemodynamic instability Maternal Systolic <90 mmHg Maternal cardiopulmonary symptoms (e.g. , ) IV. Preparations: Preferred Tocolytics ral Indications Stops labor for 24-48 hours Allows maternal transport and doses Load: 6 grams bolus IV over 20 min (Very high dose!, some protocols use 4 g load) Maintenance: 2 grams/hour IV infusion (max: 3 g/h) Must follow protocols for patient safety Tocolytic

2015 FP Notebook

44. Assessing the quality of evidence for preterm labor tocolytic trials.

Assessing the quality of evidence for preterm labor tocolytic trials. To assess the quality of tocolysis randomized controlled trials (RCTs) and to determine trial factors contributing to better quality evidence.The Cochrane Central Register of Controlled Trials, MEDLINE, MEDLINE In-Process, EMBASE and CINAHL were searched for terms "preterm labor," "tocolytic" or "obstetric labor, premature" up to 1 August 2009.Data regarding study design, characteristics, number of participants and outcomes (...) reported were extracted by at least two review authors. Study quality was assigned using the Cochrane Collaboration Handbook methodology and categories. Trends for quality over time, the impact of study size and the individual drugs compared were analyzed for impact on overall quality of trials.Of the 3197 titles initially identified, 89 RCTs of tocolytic therapy were reviewed. Of the six quality areas, 10 (11.2%) trials satisfied all areas, while only one trial (1.1%) met one area. The mean number

2012 The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians

45. The tocolytic role of nifedipine in preventing preterm labour pain. (PubMed)

The tocolytic role of nifedipine in preventing preterm labour pain. This study was undertaken to evaluate the efficacy of oral nifedipine to reduce labour pain in patient with preterm labour, to complete the doses of steroids in lung maturity and in utero transfer to the Neonatal Intensive Care Unit (NICU) and to evaluate the maternal adverse effects and neonatal outcome. Diagnosed cases of preterm labour (between 24 to 34 weeks gestation) were randomly selected. Among them 50 patients were (...) nifedipine in patients with preterm labour pain as Tocolytic therapy has significantly prolonged pregnancy with lesser neonatal problems and fewer maternal adverse effects.

2012 Mymensingh medical journal : MMJ

46. Outcome of vaginal progesterone as a tocolytic agent: randomized clinical trial. (PubMed)

Outcome of vaginal progesterone as a tocolytic agent: randomized clinical trial. Vaginal progesterone has a potential beneficial effect in postponing of preterm labor by suppression of prostaglandins cascades. Although different studies evaluated the use of progesterone for preterm birth, the exact effect of which on prolongation of pregnancy remains unclear. Seventy two women who underwent preterm labor were managed by magnesium sulfate. Then they were randomly assigned to continue pregnancy

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2012 ISRN obstetrics and gynecology

47. Tocolytics for preterm premature rupture of membranes. (PubMed)

Tocolytics for preterm premature rupture of membranes. In women with preterm labor, tocolysis has not been shown to improve perinatal mortality; however, it is often given for 48 hours to allow for the corticosteroid effect for fetal maturation. In women with preterm premature rupture of membranes (PPROM), the use of tocolysis is still controversial. In theory, tocolysis may prolong pregnancy in women with PPROM, thereby allowing for the corticosteroid benefit and reducing the morbidity (...) and mortality associated with prematurity.To assess the potential benefits and harms of tocolysis in women with preterm premature rupture of membranes.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (6 April 2011), CENTRAL (The Cochrane Library 2011, Issue 1), MEDLINE (1966 to 6 April 2011) and EMBASE (1974 to 6 April 2011).We included pregnant women with singleton pregnancies and PPROM (23 weeks to 36 weeks and six days). We included any tocolytic therapy compared to no tocolytic

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2011 Cochrane database of systematic reviews (Online)

48. Different effects of tocolytic medication on blood pressure and blood pressure amplification. (PubMed)

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

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2011 European journal of clinical pharmacology

49. The influence of tocolytic drugs on cardiac function, large arteries, and resistance vessels. (PubMed)

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

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2011 European journal of clinical pharmacology

50. Magnesium sulfate as a second-line tocolytic agent for preterm labor: a randomized controlled trial in kyushu island. (PubMed)

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

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2011 Journal of pregnancy

51. Effect of progesterone as a tocolytic and in maintenance therapy during preterm labor. (PubMed)

Effect of progesterone as a tocolytic and in maintenance therapy during preterm labor. To assess the efficacy of vaginal micronized natural progesterone as a tocolytic and in maintenance therapy during threatened preterm birth.Eighty-three women with symptoms of threatened preterm birth were either randomized to study groups receiving tocolytic treatment combined with intravaginal micronized natural progesterone (200 mg daily) or to a control group receiving only tocolysis.Micronized natural (...) progesterone treatment resulted in a prolonged latency period of 32.1 ± 17.8 versus 21.2 ± 16.3 days in the control group and heavier birth weights of 2,982.8 ± 697.8 g versus 2,585.3 ± 746.6 g. No significant differences were found between the groups in admission to the neonatal intensive care unit, stay at the neonatal intensive care unit, need for a mechanical ventilator, respiratory distress syndrome or neonatal sepsis.The treatment of threatened preterm birth with tocolytics combined with intravaginal

2011 Gynecologic and obstetric investigation

52. Inhibition of uterine contractility with various tocolytics with and without progesterone: in vitro studies. (PubMed)

Inhibition of uterine contractility with various tocolytics with and without progesterone: in vitro studies. Various tocolytics are used to suppress uterine contractility in patients in preterm labor. Progesterone (P4) is used in patients at high risk for preterm delivery. In this study, we evaluated the effects of various tocolytics with and without P4 to examine effects on uterine contractility.Uterine tissues (n = 280) from women undergoing cesarean at term were exposed in vitro to various

2011 American Journal of Obstetrics and Gynecology

53. Tocolytic therapy: a meta-analysis and decision analysis (PubMed)

Tocolytic therapy: a meta-analysis and decision analysis To determine the optimal first-line tocolytic agent for treatment of premature labor.We performed a quantitative analysis of randomized controlled trials of tocolysis, extracting data on maternal and neonatal outcomes, and pooling rates for each outcome across trials by treatment. Outcomes were delay of delivery for 48 hours, 7 days, and until 37 weeks; adverse effects causing discontinuation of therapy; absence of respiratory distress (...) syndrome; and neonatal survival. We used weighted proportions from a random-effects meta-analysis in a decision model to determine the optimal first-line tocolytic therapy. Sensitivity analysis was performed using the standard errors of the weighted proportions.Fifty-eight studies satisfied the inclusion criteria. A random-effects meta-analysis showed that all tocolytic agents were superior to placebo or control groups at delaying delivery both for at least 48 hours (53% for placebo compared with 75-93

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2009 EvidenceUpdates

54. Adverse drug reactions to tocolytic treatment for preterm labour: prospective cohort study. (PubMed)

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

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2009 BMJ

55. Use of isoxsuprine hydrochloride as a tocolytic agent in the treatment of preterm labour: a systematic review of previous literature.

Use of isoxsuprine hydrochloride as a tocolytic agent in the treatment of preterm labour: a systematic review of previous literature. The aim of this systematic review was to evaluate the efficacy of isoxsuprine (1-(4-hydroxyphenyl)-2-(1-methyl-2-phe-noxyethylamino)-1-propanol, CAS 395-28-8), a tocolytic agent used in both preterm labour and risk of abortion. Two analyses were conducted on data reporting the use of isoxsuprine in the prevention of preterm delivery. The first analysis examined

2010 Arzneimittel-Forschung

56. Effect of maternal body mass index on in vitro response to tocolytics in term myometrium. (PubMed)

Effect of maternal body mass index on in vitro response to tocolytics in term myometrium. We sought to investigate the effect of body mass index (BMI) on in vitro response to tocolytics.Myometrial biopsies were obtained at the time of scheduled cesarean deliveries from term nonlaboring women with BMI < or =29.9 (26.3 +/- 1.3; n = 7), 30-34.9 (31.8 +/- 1.2; n = 16), and > or = 35 (39.5 +/- 4.9; n = 9). Tissue strips were suspended in organ chambers for isometric tension recording. The effects (...) of cumulative doses (10(-10) to 10(-5) mol/L) of nifedipine or indomethacin on spontaneous uterine contractility were determined. Areas under the contraction curve were compared using 1-way analysis of variance with Tukey post hoc test.Myometrial response to tocolytics did not differ between the BMI groups. Nifedipine, but not indomethacin, significantly inhibited myometrial contractility independent of BMI.BMI does not affect uterine response to tocolytics in isolated uterine tissue from term nonlaboring

2010 American Journal of Obstetrics and Gynecology

57. Care of Women Presenting with Suspected Preterm Prelabour Rupture of Membranes from 24+0 Weeks of Gestation

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

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2019 Royal College of Obstetricians and Gynaecologists

58. Acute tocolysis for uterine tachysystole or suspected fetal distress. (PubMed)

Acute tocolysis for uterine tachysystole or suspected fetal distress. Uterine tachysystole (more than 5 contractions per 10 minutes in 2 consecutive intervals) is common during labour, particularly with use of labour-stimulating agents. Tachysystole may reduce fetal oxygenation by interrupting maternal blood flow to the placenta during contractions. Reducing uterine contractions may improve placental blood flow, improving fetal oxygenation. This review aimed to evaluate the use of tocolytics (...) section. Overall, the studies had a low risk of bias, except for methods to maintain blinding. All of the trials used a selective beta2 (ß2)-adrenergic agonist in one arm, however the drug used varied, as did the comparator. Limited information was available on maternal outcomes.Selective ß2-adrenergic agonist versus no tocolytic agent, whilst awaiting emergency deliveryThere were two stillbirths, both in the no tocolytic control group (risk ratio (RR) 0.23, 95% confidence interval (CI) 0.01 to 4.55

2018 Cochrane

59. 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

60. 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

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