Table of ContentsView AllTable of ContentsPurposeTypesContraindicationsSide Effects
Table of ContentsView All
View All
Table of Contents
Purpose
Types
Contraindications
Side Effects
In situations when a pregnant person begins showing signs ofpreterm labor—which is any time before 37 weeks of completed pregnancy—their doctor may recommend attempting to delay the process, using a category of drugs called tocolytics. The aim of postponing labor is to give the fetus more time to fully develop in the womb, and, as a result, avoid the potentialcomplications associated with preterm birth, includingbreathing difficultiesand impaired vision.
This article discusses the purpose, types, risk factors, and side effects of tocolytics.
Adam Hester / Getty Images
While a typical human pregnancy lasts about 40 weeks—from the start of a person’s last menstrual period to childbirth—the gestation period can be cut short for a variety of reasons. Any time labor starts prior to hitting the 37-week mark, it’s considered preterm (or premature)labor, which can result in a preterm birth.
Though outcomes can vary significantly among neonates, some of the more common categories of health challenges associated with preterm birth include:
In addition to tocolytics, healthcare providers may also prescribecorticosteroids— like betamethasone or dexamethasone—to help increase the speed of fetal development before childbirth takes place. While corticosteroids are not considered tocolytics (given that they have a different function), the two types of medications are often prescribed together, especially if the preterm labor begins between 24 and 34 weeks of gestation.
Finally, it’s important to keep in mind that tocolytics alone have not been shown to directly improve neonatal outcomes: Their function is to help delay the labor process itself. This is why they’re often used in conjunction with corticosteroids.
Timing of TocolyticsTocolytics are meant for short-term use. There is no evidence that taking the medications over an extended period of time can further postpone delivery or improve neonatal outcomes.
Timing of Tocolytics
Tocolytics are meant for short-term use. There is no evidence that taking the medications over an extended period of time can further postpone delivery or improve neonatal outcomes.
Several different classes of drugs are used for tocolysis, including:
There is not currently a single medication that has emerged as the safest and most effective tocolytic, so medical professionals have to weigh the risks and benefits of the different options for each person. This includes:
Are Tocolytics FDA-Approved?
Consequently, the use of tocolytic medications to manage preterm labor is all done off-label. At present, some researchers believe that based on weighing the risks and benefits, repurposing FDA-approved drugs is preferable to traditional drug development.
There are a number of contraindications for the use of tocolytics. In most cases, this is because the benefit of delivering someone preterm outweighs attempting to keep them pregnant until full term. These contraindications include:
Betamimetics
Calcium channel blockers
Magnesium sulfate
Oxytocin receptor blockers
Prostaglandin inhibitors
Nitrates and others
Summary
Tocolytics are a category of drugs used to delay the labor process. These may be used in situations when a pregnant person begins showing signs ofpreterm labor—which is any time before 37 weeks of completed pregnancy.
A Word From Verywell
In addition to tocolytics and corticosteroids, there are increasingly advanced therapeutic and incubation methods in the event of a preterm birth. Your healthcare providers will be able to walk you through different options and discuss which might work best for you.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Eunice Kennedy Shriver National Institute of Child Health and Human Development.What treatments can reduce the chances of preterm labor & birth?Cleveland Clinic.Fetal development: stages of growth.American Academy of Pediatrics.Health issues of premature babies.Rundell K, Panchal B.Preterm labor: prevention and management.AFP. 2017;95(6):366-372. PMID: 28318214.Haas DM, Caldwell DM, Kirkpatrick P, McIntosh JJ, Welton NJ.Tocolytic therapy for preterm delivery: systematic review and network meta-analysis.BMJ. 2012;345:e6226. doi: 10.1136/bmj.e6226.Siricilla S, Rogers JH, Lambert LA, Simpson CL, Herington JL.Identification of FDA approved drugs and their synergistic combinations as potent and selective regulators of uterine contractility for therapeutic control of preterm labor.The FASEB Journal. 2020;34(S1):1-1. doi: 10.1096/fasebj.2020.34.s1.05778American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics.Practice bulletin no. 171: management of preterm labor.Obstet Gynecol. 2016;128(4):e155-164. doi: 10.1097/AOG.0000000000001711.Haas DM, Benjamin T, Sawyer R, Quinney SK.Short-term tocolytics for preterm delivery – current perspectives.Int J Womens Health. 2014;6:343-349. doi: 0.2147/IJWH.S44048.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Eunice Kennedy Shriver National Institute of Child Health and Human Development.What treatments can reduce the chances of preterm labor & birth?Cleveland Clinic.Fetal development: stages of growth.American Academy of Pediatrics.Health issues of premature babies.Rundell K, Panchal B.Preterm labor: prevention and management.AFP. 2017;95(6):366-372. PMID: 28318214.Haas DM, Caldwell DM, Kirkpatrick P, McIntosh JJ, Welton NJ.Tocolytic therapy for preterm delivery: systematic review and network meta-analysis.BMJ. 2012;345:e6226. doi: 10.1136/bmj.e6226.Siricilla S, Rogers JH, Lambert LA, Simpson CL, Herington JL.Identification of FDA approved drugs and their synergistic combinations as potent and selective regulators of uterine contractility for therapeutic control of preterm labor.The FASEB Journal. 2020;34(S1):1-1. doi: 10.1096/fasebj.2020.34.s1.05778American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics.Practice bulletin no. 171: management of preterm labor.Obstet Gynecol. 2016;128(4):e155-164. doi: 10.1097/AOG.0000000000001711.Haas DM, Benjamin T, Sawyer R, Quinney SK.Short-term tocolytics for preterm delivery – current perspectives.Int J Womens Health. 2014;6:343-349. doi: 0.2147/IJWH.S44048.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Eunice Kennedy Shriver National Institute of Child Health and Human Development.What treatments can reduce the chances of preterm labor & birth?Cleveland Clinic.Fetal development: stages of growth.American Academy of Pediatrics.Health issues of premature babies.Rundell K, Panchal B.Preterm labor: prevention and management.AFP. 2017;95(6):366-372. PMID: 28318214.Haas DM, Caldwell DM, Kirkpatrick P, McIntosh JJ, Welton NJ.Tocolytic therapy for preterm delivery: systematic review and network meta-analysis.BMJ. 2012;345:e6226. doi: 10.1136/bmj.e6226.Siricilla S, Rogers JH, Lambert LA, Simpson CL, Herington JL.Identification of FDA approved drugs and their synergistic combinations as potent and selective regulators of uterine contractility for therapeutic control of preterm labor.The FASEB Journal. 2020;34(S1):1-1. doi: 10.1096/fasebj.2020.34.s1.05778American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics.Practice bulletin no. 171: management of preterm labor.Obstet Gynecol. 2016;128(4):e155-164. doi: 10.1097/AOG.0000000000001711.Haas DM, Benjamin T, Sawyer R, Quinney SK.Short-term tocolytics for preterm delivery – current perspectives.Int J Womens Health. 2014;6:343-349. doi: 0.2147/IJWH.S44048.
Eunice Kennedy Shriver National Institute of Child Health and Human Development.What treatments can reduce the chances of preterm labor & birth?
Cleveland Clinic.Fetal development: stages of growth.
American Academy of Pediatrics.Health issues of premature babies.
Rundell K, Panchal B.Preterm labor: prevention and management.AFP. 2017;95(6):366-372. PMID: 28318214.
Haas DM, Caldwell DM, Kirkpatrick P, McIntosh JJ, Welton NJ.Tocolytic therapy for preterm delivery: systematic review and network meta-analysis.BMJ. 2012;345:e6226. doi: 10.1136/bmj.e6226.
Siricilla S, Rogers JH, Lambert LA, Simpson CL, Herington JL.Identification of FDA approved drugs and their synergistic combinations as potent and selective regulators of uterine contractility for therapeutic control of preterm labor.The FASEB Journal. 2020;34(S1):1-1. doi: 10.1096/fasebj.2020.34.s1.05778
American College of Obstetricians and Gynecologists’ Committee on Practice Bulletins—Obstetrics.Practice bulletin no. 171: management of preterm labor.Obstet Gynecol. 2016;128(4):e155-164. doi: 10.1097/AOG.0000000000001711.
Haas DM, Benjamin T, Sawyer R, Quinney SK.Short-term tocolytics for preterm delivery – current perspectives.Int J Womens Health. 2014;6:343-349. doi: 0.2147/IJWH.S44048.
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