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Calcium channel blockers as tocolytics.
1Division of Maternal Fetal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Seminars in Perinatology
|November 15, 2001
Summary
Calcium channel blockers are effective and safe for managing preterm labor. These tocolytic agents demonstrate efficacy comparable to other treatments with fewer maternal side effects and no adverse fetal outcomes.
Area of Science:
- Obstetrics and Gynecology
- Pharmacology
Background:
- Preterm labor is a significant concern in obstetrics.
- Tocolytic agents are used to inhibit uterine contractions.
- Calcium channel blockers represent a class of drugs with potential tocolytic properties.
Purpose of the Study:
- To review the safety and efficacy of calcium channel blockers (CCBs) as tocolytic agents.
- To analyze clinical and basic science data on CCBs in managing preterm labor.
Main Methods:
- Comprehensive literature review of English language studies.
- MEDLINE search (1966-2000) using terms related to CCBs and preterm labor.
- Inclusion of animal data and human clinical trials, including randomized controlled trials.
Main Results:
- Nifedipine and nicardipine are commonly used CCBs for tocolysis.
- CCBs inhibit calcium influx, reducing vascular smooth muscle tone and acting as vasodilators.
- Randomized clinical trials show CCBs are as effective as beta-mimetics and magnesium for tocolysis.
- CCBs have fewer maternal side effects compared to other tocolytics and no adverse fetal effects.
Conclusions:
- Calcium channel blockers are a safe and effective option for tocolysis in preterm labor.
- CCBs offer a favorable side effect profile for both mother and fetus compared to alternative agents.