Tocolytic medications
PREGNANCY
Evidence
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD014978.pub2/full
Amie Wilson, Victoria A Hodgetts-Morton, Ella J Marson, Alexandra D Markland, Eva Larkai, Argyro Papadopoulou, Arri Coomarasamy, Aurelio Tobias, Doris Chou, Olufemi T Oladapo, Malcolm J Price, Katie Morris, Ioannis D Gallos
Preterm birth is the leading cause of death in newborns and children. Tocolytic drugs aim to delay preterm birth by suppressing uterine contractions to allow time for administration of corticosteroids for foetal lung maturation, magnesium sulphate for neuroprotection, and transport to a facility with appropriate neonatal care facilities.
Education
If you are showing signs of preterm labour and are less than 34 weeks pregnant, your doctor may administer tocolytic medications that slow or stop labour contractions. Tocolytics work by relaxing the muscles in the pregnant uterus.
The primary aim for the use of tocolytics is to delay preterm birth for up to 48 hours. This provides time for:
- Administration of corticosteroid therapy to promote your baby’s lung maturation.
- Transfer to a higher-level care with a Neonatal Intensive Care Unit - You can find your nearest suitable hospital here.
- Administration of magnesium sulphate for your baby’s neuroprotection, which protects the baby’s brain from adverse effects.
- Administration of calcium channel blocker that relax uterine contractions.
- Administration of corticosteroid therapy to promote your baby’s lung development - Even a couple of days of steroids can improve a baby’s lung function while labour is being delayed.
Maternal corticosteroids and birth at an appropriate facility significantly improve neonatal outcomes.
Tocolytics are given when the benefits of the treatment outweigh the risks. Tocolytics typically are not given when;
- there are preterm labour symptoms but no changes in the cervix
- it is thought that delivery would be better for you or your baby
- preterm labour has stopped
Tocolytics may not be prescribed for women with certain health conditions, such as severe bleeding, which may be caused by the placenta detaching from the wall of the uterus, a rare condition called placental abruption. In these situations, labour may be allowed to progress for the safety of both the mother and the baby.
If labour is successfully stopped, you may be sent home from the hospital, and your doctor may ask that you restrict certain activities to prevent a recurrence of preterm labour symptoms.
Empowerment
It may now be the time to consider the likelihood of experiencing a premature birth and to ask any questions about what to expect.
Feeling fully informed and knowing what to expect may make you feel prepared.
It is completely natural to experience anxiety if you are in preterm labour and are going into hospital to have medications to try to stop your baby’s early arrival.
It is important to accept and acknowledge that you are likely to need support at this time.
Don’t be afraid to ask lots of questions or ask doctors to explain terms you don’t understand. And take notes if you need to.
Useful Links
The Australian Preterm Birth Prevention Alliance
https://www.pretermalliance.com.au/Our-Research/Clinical-Guidelines
https://www.pretermalliance.com.au/About-Preterm-Birth/Causes-Of-Preterm-Birth
South Australian Perinatal Practice Guidelines
Miracle Babies Foundation
https://www.miraclebabies.org.au/content/hints-tips-from-other-parents/gjrjvs
PANDA - Perinatal Anxiety & Depression Australia
For When – Perinatal Mental Health and Wellbeing
Need support? NurtureConnect allows you to connect with our NurtureProgram support team, or call our 24 hour NurtureLine 1300 622 243 or join our Facebook community.
Confirmation Content
Need support? NurtureConnect allows you to connect with our NurtureProgram support team.
Nurture Connect
Disclaimer: This publication by Miracle Babies Foundation is intended solely for general education and assistance and it is it is not medical advice or a healthcare recommendation. It should not be used for the purpose of medical diagnosis or treatment for any individual condition. This publication has been developed by our Parent Advisory Team (all who are parents of premature and sick babies) and has been reviewed and approved by a Clinical Advisory Team. This publication is not a substitute for professional medical advice. Miracle Babies Foundation recommends that professional medical advice and services be sought out from a qualified healthcare provider familiar with your personal circumstances. To the extent permitted by law, Miracle Babies Foundation excludes and disclaims any liability of any kind (directly or indirectly arising) to any reader of this publication who acts or does not act in reliance wholly or partly on the content of this general publication. If you would like to provide any feedback on the information please email [email protected].
Inspirational stories, delivered to your inbox.
