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Management of preterm labor: atosiban or nifedipine?

Roel de Heus1, Eduard J H Mulder, Gerard H A Visser

  • 1Department of Woman and Baby, University Medical Centre Utrecht, The Netherlands.

International Journal of Women'S Health
|November 13, 2010
PubMed

Preterm birth is strongly associated with neonatal death and long-term neurological morbidity. The purpose of tocolytic drug administration is to postpone threatening preterm delivery for 48 hours to allow maximal effect of antenatal corticosteroids and maternal transportation to a center with specialized neonatal care facilities. There is uncertainty about the value of atosiban (oxytocin receptor antagonist) and nifedipine (calcium channel blocker) as first-line tocolytic drugs in the management of preterm labor. For nifedipine, concerns have been raised about unproven safety, lack of placebo-controlled trials, and its off-label use. The tocolytic efficacy of atosiban has also been questioned because of a lack of reduction in neonatal morbidity. This review discusses the available evidence, the pros and cons of either drug and aims to provide information to support a balanced choice of first-line tocolytic drug: atosiban or nifedipine?

Keywords:
atosibancalcium channel blockernifedipineoxytocin receptor antagonistpreterm birthpreterm labortocolytic drugs

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