Why are tocolytics contraindicated in preeclampsia?
All the tocolytic agents are associated with serious side effects to both the mother and fetus. Tocolytic therapy is contraindicated for prolonging pregnancy in cases of chorioamnionitis, fetal death, or severe pregnancy induced hypertension (Wilkins and Creasy, 1990).
What are examples of tocolytics?
Several different classes of drugs are used for tocolysis, including:
- Betamimetics (such as terbutaline)
- Magnesium sulfate.
- Prostaglandin inhibitors (like indomethacin, ketorolac)
- Calcium channel blockers (such as nifedipine)
- Nitrates (like nitroglycerine)
- Oxytocin receptor blockers (such as atosiban)
When should you not use tocolytics?
Contraindications
- A gestational age above 34 weeks.
- Intrauterine fetal demise.
- Lethal fetal anomaly.
- Nonreassuring fetal status.
- Severe preeclampsia or eclampsia.
- Maternal bleeding with hemodynamic instability.
- Chorioamnionitis.
Who should not use tocolytic medications?
Who should not use tocolytic medications?
- mild preeclampsia.
- relatively stable bleeding during the second or third trimester.
- serious medical conditions.
- a cervix that has already dilated 4 to 6 centimeters or more.
Why are tocolytics contraindicated in placental abruption?
In general, either magnesium sulfate or nifedipine (but not both) is used for tocolysis and beta-sympathomimetic agents are avoided, as the latter may cause significant undesirable cardiovascular effects, such as tachycardia, which may mask clinical signs of blood loss in these patients.
What is the difference between tocolytics & Uterotonics?
Medications that relax the muscle in the pregnant uterus – tocolytics – or increase uterine contraction – uterotonics – play a vital role in modern obstetric care.
How long does tocolytic last?
Tocolytics are medications used to delay delivery, sometimes for up to 48 hours.
What are the effects of tocolytic therapy?
Side effects: Tachycardia, hypotension, palpitations, shortness of breath, chest pain, pulmonary edema, hypokalemia, hyperglycemia. Contraindications include tachycardia-sensitive maternal cardiac conditions.
What are the indications for tocolytics?
Tocolytics are considered for women with confirmed preterm labor between 24 and 34 weeks of gestation age and used in conjunction with other therapies that may include corticosteroids administration, fetus neuroprotection, and safe transfer to facilities.
What is the purpose of administering Pitocin during childbirth?
Pitocin® is a synthetic version of oxytocin, and doctors use this IV medication for labor induction. This drug helps imitate natural labor and birth by causing the uterus to contract.
What is dexamethasone used for in pregnancy?
Conclusion: Dexamethasone accelerates maturation of fetal lungs, decrease number of neonates with respiratory distress syndrome and improves survival in preterm delivered neonates. Optimal gestational age for use of dexamethasone therapy is 31 to 34 weeks of gestation.
What is tocolytic effect?
Tocolytic agents are drugs designed to inhibit contractions of myometrial smooth muscle cells. Such an effect has been demonstrated in vitro or in vivo for several pharmacological agents, including beta-adrenergic agonists, calcium channel antagonists, oxytocin antagonists, NSAIDs and magnesium sulfate.