title: Preterm labor: current pharmacotherapy options for tocolysis.
abstract: BACKGROUND
  In the developed world, preterm birth is in quantity and in severity the most important issue in obstetric care. Adverse neonatal outcome is strongly related to gestational age at delivery. Since the pathophysiological mechanism of preterm birth is not yet completely unraveled, the development of successful preventive strategies is hampered. When preterm labor is actually threatening, current pharmacological therapies focus on inhibition of preterm contractions. This allows for transportation of the mother to a center with a neonatal intensive care unit and administration of corticosteroids to enhance fetal lung maturation. Globally, however, large practice variation exists.
  
  
  METHODS
  The aim of this review is to provide an overview of current pharmacological therapies for preterm labor.
  
  
  CONCLUSIONS
  For the initial tocolysis, the use of atosiban or nifedipine for 48 h is recommended based on the largest effectiveness and most favorable side effect profile. However, since data that convincingly indicate the beneficial effect of tocolytics on neonatal outcome are lacking, it might well be that tocolytics are ineffective. The role of progesterone in treatment of acute tocolysis is limited, but it might play a role in the prevention of preterm labor or as sensitizer for other tocolytic agents.
authors.affiliation: UMC Utrecht, Department of Obstetrics and Gynaecology , WKZ, PO Box 85090, 3508 AB Utrecht , Netherlands e.o.g.vanvliet@umcutrecht.nl.
authors.forename: Elvira O G
authors.initials: EO
authors.lastname: van Vliet
authors.forename: Elisabeth M
authors.initials: EM
authors.lastname: Boormans
authors.forename: Thomas S
authors.initials: TS
authors.lastname: de Lange
authors.forename: Ben W
authors.initials: BW
authors.lastname: Mol
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Oudijk
mesh_terms: D005260:Female; D006801:Humans; D007231:Infant, Newborn; D009543:Nifedipine / Q000627:therapeutic use; D007752:Obstetric Labor, Premature / Q000517:prevention & control*; D011247:Pregnancy; D047928:Premature Birth / Q000517:prevention & control; D011374:Progesterone / Q000627:therapeutic use; D011372:Progestins / Q000627:therapeutic use; D015145:Tocolysis; D015149:Tocolytic Agents / Q000627:therapeutic use; D014668:Vasotocin / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D011372:Progestins; D015149:Tocolytic Agents; C047046:atosiban; D011374:Progesterone; D009543:Nifedipine; D014668:Vasotocin