Maintenance tocolysis with calcium channel blockers

Journal de gynécologie, obstétrique et biologie de la reproduction
E Maisonneuve, B Carbonne

Abstract

The objective of initial tocolysis is to prolong pregnancy for 48 hours, in order to allow fetal lung maturation with corticosteroids. Maintenance tocolysis is defined by the prolongation of tocolytic therapy beyond 48 h. Although the 2002 guidelines of the French College did not recommend to prolong tocolysis beyond 48 h, about 60% of obstetricians prescribe maintenance tocolysis. Nifedipine is the most frequently used treatment for maintenance tocolysis. Five randomised studies and two metaanalyses have compared maintenance tocolysis with nifedipine, with placebo or no treatment. Maintenance tocolysis with calcium channel blockers does not reduce the risk of preterm birth and does not improve perinatal outcome. Tocolytic treatment after 48 hours of initial tocolysis has no beneficial effect (level of evidence 1).

References

Oct 16, 1999·American Journal of Obstetrics and Gynecology·D B CarrJ A Spinnato
Jun 11, 2004·Journal of Perinatal Medicine·N Cenk SayinMüge Sayin
Nov 28, 2008·BJOG : an International Journal of Obstetrics and Gynaecology·O ParantUNKNOWN EVAPRIMA Group
Feb 3, 2011·American Journal of Obstetrics and Gynecology·Agustín Conde-AgudeloJuan Pedro Kusanovic
Mar 3, 2012·American Journal of Obstetrics and Gynecology·Patrick RozenbergUNKNOWN Groupe De Recherche En Obstétrique et Gynécologie
May 1, 2012·American Journal of Obstetrics and Gynecology·UNKNOWN Society for Maternal-Fetal Medicine Publications Committee, with assistance of Vincenzo Berghella
Jan 3, 2013·JAMA : the Journal of the American Medical Association·Carolien RoosUNKNOWN APOSTEL-II Study Group
Feb 4, 2014·Journal of Obstetrics and Gynaecology : the Journal of the Institute of Obstetrics and Gynaecology·S KamatR Rani

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