title: Tocolytic preference for treatment of preterm labor.
abstract: Preterm labor remains the most common complication of pregnancy. Although tocolytic treatment is the standard of care in such women, there is no FDA approved drug for therapy, and there is no unanimity of drug regimens among physicians. This survey details the patterns of twenty Maternal-Fetal Medicine specialists who manage over 6,000 cases of preterm labor with intact membranes annually. Approximately 90% of women were seen early enough to be effectively treated with tocolytics, and over 90% of these subjects received corticosteroids. First-line tocolytic use favored magnesium sulfate while antiprostaglandin drugs were the leading second-line drug whereas intravenous terbutaline and calcium channel antagonists were used less often. There were many different dosage patterns for each drug as well as combinations of various tocolytic drugs which were individually adjusted for patient circumstances. Women with preterm labor and intact membranes are usually treated with tocolytics and corticosteroids, but regimens are varied and all use is off label. This study demonstrates the need for an FDA approved tocolytic which could be used consistently for such women.
authors.affiliation: Department of Obstetrics & Gynecology, University of Mississippi Medical Center, Jackson 39216, USA.
authors.forename: Chad K
authors.initials: CK
authors.lastname: Klauser
authors.forename: Christian M
authors.initials: CM
authors.lastname: Briery
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.forename: Rick W
authors.initials: RW
authors.lastname: Martin
authors.forename: Suneet P
authors.initials: SP
authors.lastname: Chauhan
authors.forename: John C
authors.initials: JC
authors.lastname: Morrison
mesh_terms: D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature; D011247:Pregnancy; D015149:Tocolytic Agents / Q000627:therapeutic use*
chemical_list: D015149:Tocolytic Agents