Authors: Ann-Sophie Page,  Geert Herman Page

Abstract

To gather and appraise the most recent evidence about the effectiveness of tocolysis to prevent bad perinatal outcomes in preterm births. A systematic literature review was carried out up to April 2016 along with the analysis of data presented during several international congresses. The diagnosis of preterm labour is now made reasonably accurately using cervical length measurement, combined with a (variant of the) fibronectin test. Tocolysis may, in comparison with placebo (53%) delay birth by 48 hours (75-93%). The added value of transportation to a tertiary centre with a neonatal intensive care unit (NICU) is no longer in question, and neither is the added value of antenatal corticosteroids. Two tocolytic agents, nifedipine and atosiban, are currently used for this purpose. However, there is still a demand for randomised evidence of the effect of tocolysis on better perinatal outcomes. Tocolysis for 48 hours is recommended to allow for intra-uterine transport and the timely delivery of antenatal corticosteroids. Future research has to focus on efficient and safe tocolytic agents. Atosiban is currently the product with the best “effectiveness/side-effect ratio” to postpone delivery in preterm labour, when indicated.

Keywords

Tocolysis, preterm, labour, perinatal outcome

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TOCOLYSIS in 2016: An Evidence-Based Clinical Review