[Long-term tocolysis--sense and nonsense in current practice]

Preterm delivery is still a major medical and social problem in perinatology. Despite many efforts the appliance of efficient prevention methods is still not possible. The treatment and inhibition of uterine contractions is widely used in clinical practice. The use of tocolytic agents in arresting premature labor is justified by gaining time which is necessary for applying antibiotics and steroids. Short-term tocolysis, ordinarily used between 22 and 34 weeks gestation, prolongs pregnancy and usually delays the delivery by about 48 hours. There are two prevailing options to follow successful inhibition of preterm contractions. The first one recommends intravenous treatment in cases with recurrent premature contractions, the other recommends long-term tocolysis even in cases with no any threatening symptoms. In such cases many obstetricians apply oral beta-Adrenergic agonists, although most of literature data and clinical practice do not confirm good results in preventing premature labor long-term tocolytic therapy does not improve fetal condition and does not prolong the pregnancy. It is also not meaningless that during this therapy maternal adverse effects may occur. Taking the above into consideration long-term tocolysis cannot be recommended as the routine treating procedure.