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Use of antenatal corticosteroids and tocolytic drugs in preterm births in 29 countries: an analysis of the WHO Multicountry Survey on Maternal and Newborn Health. Despite the global burden of morbidity and mortality associated with preterm birth, little evidence is available for use of antenatal corticosteroids and tocolytic drugs in preterm births in low-income and middle-income countries. We analysed data from the WHO Multicountry Survey on Maternal and Newborn Health (WHOMCS) to assess (...) antenatal corticosteroids are known to be most beneficial. We also calculated use in women at 22-25 weeks' and 34-36 weeks' gestation. We assessed tocolytic drug use, with and without antenatal corticosteroids, in spontaneous, uncomplicated preterm deliveries at 26-34 weeks' gestation.Of 303,842 recorded deliveries after 22 weeks' gestation, 17,705 (6%) were preterm. 3900 (52%) of 7547 women who gave birth at 26-34 weeks' gestation, 94 (19%) of 497 women who gave birth at 22-25 weeks' gestation
Tocolytic therapy for preterm delivery: systematic review and network meta-analysis Tocolytic therapy for preterm delivery: systematic review and network meta-analysis Tocolytic therapy for preterm delivery: systematic review and network meta-analysis Haas DM, Caldwell DM, Kirkpatrick P, McIntosh JJ, Welton NJ CRD summary This review concluded that prostaglandin inhibitors and calcium channel blockers had the highest probability of delaying delivery and improving neonatal and maternal outcomes (...) . This was a generally well-conducted review and the conclusions are likely to be reliable based on the information available. Authors' objectives To determine the most effective tocolytic agent at delaying delivery in women at risk of preterm delivery. Searching MEDLINE, EMBASE, CINAHL and Cochrane Central Register of Controlled Trials (CENTRAL) were searched without language restrictions to 2012; search terms were reported. Bibliographies of Cochrane reviews were searched for additional studies. Abstracts
Use of isoxsuprine hydrochloride as a tocolytic agent in the treatment of preterm labour: a systematic review of previous literature Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
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
The use of tocolytic therapy in a pregnant trauma patient BestBets: The use of tocolytic therapy in a pregnant trauma patient The use of tocolytic therapy in a pregnant trauma patient Report By: Helene Svinos - Medical Student Search checked by Anna O' Malley - Medical Student Institution: University of Manchester Date Submitted: 9th June 2008 Date Completed: 11th March 2009 Last Modified: 11th March 2009 Status: Green (complete) Three Part Question In a [pregnant trauma patient] does (...) [tocolytic therapy] improve [outcome for mother and foetus]? Clinical Scenario A pregnant woman of 32 weeks gestation is admitted to the ED after a fall. She has blunt abdominal trauma and is having what seem to be uterine contractions. You wonder whether you start tocolytic therapy to try to prevent or delay a premature delivery and so prevent some of the possible complications for both mother and baby. Search Strategy Medline 1950 to November week 1 2008 using Ovid Interface EMBASE 1980-2008 Week 1
Clinical and cost-effectiveness of continuous subcutaneous terbutaline versus oral tocolytics for treatment of recurrent preterm labor in twin gestations Clinical and cost-effectiveness of continuous subcutaneous terbutaline versus oral tocolytics for treatment of recurrent preterm labor in twin gestations Clinical and cost-effectiveness of continuous subcutaneous terbutaline versus oral tocolytics for treatment of recurrent preterm labor in twin gestations Lam F, Bergauer N K, Jacques D (...) , Coleman S K, Stanziano G J Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Two methods of treating recurrent preterm labour in twin gestations, continuous subcutaneous terbutaline (SQT) and oral tocolytics (PO), were examined. Type
Tocolytics for suspected intrapartum fetal distress. Prophylactic tocolysis with betamimetics and other agents has become widespread as a treatment for fetal distress. Uterine relaxation may improve placental blood flow and therefore fetal oxygenation. However there may also be adverse maternal cardiovascular effects.The objective of this review was to assess the effects of tocolytic therapy for suspected fetal distress on fetal, maternal and perinatal outcomes.We searched the Cochrane (...) Pregnancy and Childbirth Group trials register and the Cochrane Controlled Trials Register. Date of last search: February 1999.Randomised trials comparing tocolytic therapy with no treatment or treatment with another tocolytic agent for suspected fetal distress.Two reviewers assessed trial quality and extracted data.Three studies were included. Compared with no treatment, there were fewer failed improvements in fetal heart rate abnormalities with tocolytic therapy (relative risk 0.26, 95% 0.13 to 0.53
Tocolytic therapy for preterm labor Tocolytic therapy for preterm labor Tocolytic therapy for preterm labor Institute for Clinical Systems Improvement Record Status This is a bibliographic record of a published health technology assessment. No evaluation of the quality of this assessment has been made for the HTA database. Citation Institute for Clinical Systems Improvement. Tocolytic therapy for preterm labor. Bloomington MN: Institute for Clinical Systems Improvement (ICSI) 2000 Authors (...) ' objectives This review aims to assess the available evidence on the effectiveness of tocolytic therapy for preterm labor. Authors' conclusions With regard to the use of tocolytic therapy for preterm labor, the ICSI Technology Assessment Committee finds the following: The effectiveness of magnesium sulfate, nifedipine, and ritodrine may be comparable when used to delay delivery for 24 to 48 hours but with limited data from placebo-controlled trials it is impossible to conclude that any of the agents
Tocolytics for preterm labor: a systematic review Tocolytics for preterm labor: a systematic review Tocolytics for preterm labor: a systematic review Gyetvai K, Hannah M E, Hodnett E D, Ohlsson A Authors' objectives To examine the effectiveness of any tocolytic compared with a placebo or no tocolytic for preterm labour. Searching The authors searched the MEDLINE (1966-1998) electronic database and the Cochrane Controlled Trials Register using the search terms: 'randomized controlled trial' (RCT (...) -up exceeded 20% of those originally enrolled, or if data was not reported on a per-patient-treated basis. Specific interventions included in the review Tocolytics for the intervention group and placebo or no tocolytic for the control group. Tocolytics used in the intervention group included: isxuprine, ethanol, terbutaline, ritodrine, indomethacin, magnesium sulfate and atosiban. The dosages are not stated. Participants included in the review Women in preterm labour. Outcomes assessed
Evidence for magnesium sulfate as a tocolytic agent Evidence for magnesium sulfate as a tocolytic agent Evidence for magnesium sulfate as a tocolytic agent Macones G A, Sehdev H M, Berlin M, Morgan M A, Berlin J A Authors' objectives To assess the efficacy and side-effects of magnesium sulfate for acute tocolysis, compared with both placebo and beta-agonists. Searching Two authors independently searched MEDLINE from 1966 to 1996 for RCTs published in the English language, using the keywords (...) and death, and whether individual tocolytes increase the risk of adverse outcomes. Bibliographic details Macones G A, Sehdev H M, Berlin M, Morgan M A, Berlin J A. Evidence for magnesium sulfate as a tocolytic agent. Obstetrical and Gynecological Survey 1997; 52(10): 652-658 PubMedID Other publications of related interest 1. Chalmers TC, Smith H, Blackburn B, Silverman B, Schroeder B, Reitman D, et al. A method for assessing the quality of a randomized control trial. Control Clin Trials 1981;2:31-49. 2