Prostaglandin endoperoxide H synthase inhibitors and other tocolytics in preterm labour.
Preterm delivery (<37 weeks of gestation) is the major obstetrical complication in developed countries, yet attempts to delay labour and prolong pregnancy have largely been unsuccessful. One of the many reasons it is so difficult to prevent preterm birth is that the nature of preterm labour changes as a function of gestational age, maternal lifestyle factors or infection, to list a few of the reasons. The inhibitors of prostaglandin endoperoxide H synthase (PGHS), known as the Non-steroidal Antiinflammatory Drugs, have been viewed with interest as tocolytics with promising effectiveness under most conditions of preterm labour. Three isoforms of PGHS exist; the first two, PGHS-1 and -2, have been studied for their catalytic activity, X-ray crystallographic structure, and physiological roles in the adult and the foetus. Mixed inhibitors and isoform-specific inhibitors of PGHS have been developed, and their roles in delaying preterm labour are examined and compared to other tocolytics.
Mitchell
Bryan F
BF
Department of Obstetrics and Gynaecology, Perinatal Research Centre, CIHR Group in Perinatal Health and Disease, University of Alberta, 220 HMRC, Edmonton, Alberta, Canada T6G2S2.
Olson
David M
DM
D000318:Adrenergic beta-Agonists / Q000494:pharmacology; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000737:chemistry / Q000494:pharmacology; D002121:Calcium Channel Blockers / Q000494:pharmacology; D016861:Cyclooxygenase Inhibitors / Q000378:metabolism / Q000494:pharmacology*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D020030:Nitric Oxide Donors / Q000494:pharmacology; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D010121:Oxytocin / Q000037:antagonists & inhibitors; D011247:Pregnancy; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism; D011453:Prostaglandins / Q000378:metabolism; D015145:Tocolysis; D015149:Tocolytic Agents / Q000378:metabolism / Q000494:pharmacology*
D000318:Adrenergic beta-Agonists; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002121:Calcium Channel Blockers; D016861:Cyclooxygenase Inhibitors; D005938:Glucocorticoids; D020030:Nitric Oxide Donors; D011453:Prostaglandins; D015149:Tocolytic Agents; D010121:Oxytocin; D011451:Prostaglandin-Endoperoxide Synthases