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Tocolysis with beta-adrenergic receptor agonists.

A B Caughey¹, J T Parer

¹Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco 94014, USA. aaroncaughey@hotmail.com

Seminars in Perinatology

|September 20, 2001

Summary

Beta-adrenergic agonists are FDA-approved for preterm labor but lack proven neonatal benefits. While effective in delaying delivery, newer agents show comparable efficacy with fewer side effects.

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Area of Science:

Obstetrics and Gynecology
Pharmacology

Background:

Beta-adrenergic receptor agonists have been utilized for tocolysis in preterm labor for over 30 years.
Ritodrine hydrochloride is the sole U.S. FDA-approved medication for treating preterm labor.

Purpose of the Study:

To review the efficacy and safety of beta-adrenergic agonists in managing preterm labor.
To compare beta-agonists with other tocolytic agents.

Main Methods:

Analysis of existing prospective randomized placebo-controlled trials.
Comparison of beta-agonist outcomes with placebo and newer tocolytic agents.

Main Results:

Beta-adrenergic agonists demonstrate efficacy in delaying delivery by at least 48 hours compared to controls.

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No significant differences in neonatal outcomes have been observed with beta-agonist use.

Newer agents like nifedipine, magnesium sulfate, and atosiban show comparable efficacy to beta-agonists but with improved side effect profiles and lower discontinuation rates.

Conclusions:

Beta-adrenergic agonists remain a common tocolytic agent due to their proven ability to delay delivery.
Despite their established role, newer tocolytic agents offer potential advantages in terms of tolerability and safety.