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If you are having preterm labor, you may be given medication. Drugs for preterm labor include:

  1. Tocolytics—to slow or stop preterm labor contractions
    1. Calcium channel blockers
    2. Prostaglandin synthetase inhibitors (cyclooxygenase inhibitors)
    3. Betamimetics
    4. Magnesium sulfate
  2. Corticosteroids—to help the baby’s lungs and brain mature
  3. Antibiotics—to prevent infection in the mother and baby

Tocolytics are drugs that minimize the strength and number of contractions. Although an ideal goal would be to stop preterm labor completely, the most that can be reasonably expected from current tocolytics is a delay of 48 hours. This delay allows time for treatment with steroids and antibiotics. Steroids are given to speed the baby’s lung development. Even a few extra days in the uterus can be vital to the baby’s development.

Antibiotics may be given to treat a suspected infection. During this time, you may also be transferred to a better-equipped hospital.

These drugs can be given through an IV or by mouth between 24 and 34 weeks gestation.

  • Common name: Nifedipine (Adalat, Procardia)

Calcium channel blockers reduce smooth muscle contractions, such as those in the uterus. In addition, statistically significant benefit has been seen for infants in terms of preventing respiratory distress syndrome, necrotizing enterocolitis, intraventricular hemorrhage, and jaundice.

Common names include:

  • Ibuprofen (Advil, Motrin)
  • Indomethacin (Indocin
  • Ketorolac (Toradol)
  • Sulindac (Clinoril)

Prostaglandins cause uterine contractions, so these drugs are meant to block the production of prostaglandin.

Common names include:

  • Terbutaline (Brethaire, Brethine, Bricanyl)
  • Ritodrine (Yutopar)

These drugs cause uterine muscles to relax.

This is a muscle relaxant that is given intravenously. While this medication has not been proven to delay preterm birth, it is effective in treating pre-eclampsia and does offer protection against brain injury in the baby. Hence, it is used frequently in the presence of preterm labor.

Common names include:

  • Betamethasone (Betatrex, Diprolene, Maxivate)
  • Dexamethasone (Decadron, Dexameth, Dexone, Hexadrol)

If you are between 24-34 weeks of pregnancy, your doctor may give corticosteroids. These drugs help your baby’s lungs mature. They also reduce the risk of respiratory distress syndrome and bleeding in the brain. With these drugs, your baby will breathe easier after delivery.

Common names include:

  • Penicillin
  • Ampicillin
  • Clindamycin
  • Vancomycin
  • Cefazolin

Antibiotics help to treat and prevent infection in both the mother and the baby. Preterm babies are at increased risk of infection because their immune systems are immature.

References:

ACOG Committee Opinion No. 291: Use of progesterone to reduce preterm birth. American College of Obstetricians and Gynecologists. 2003.

Berghella V, Klebanoff M, et al. National Institute for Child Health and Development Maternal Fetal Medicine Units Network. Sexual intercourse association with asymptomatic bacterial vaginosis and trichomonas vaginalis treatment in relationship to preterm birth Am J Obstet Gynecol. 2002;187:1277-1282.

da Fonseca EB, Bittar RE, et al. Prophylactic administration of progesterone by vaginal suppository to reduce the incidence of spontaneous preterm birth in women at increased risk: a randomized placebo-controlled double-blind study. Am J Obstet Gynecol. 2003;188:419-424.

Dodd JM, Crowther CA, et al. Progesterone supplementation for preventing preterm birth: a systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2005;84:526-533.

MacKenzie R, Walker M, et al. Progesterone for the prevention of preterm birth among women at increased risk: A systematic review and meta-analysis of randomized controlled trials. Am J Obst Gynecol. 2006;194:1234-1242.

McDonald H, Brocklehurst P, Parsons J. Antibiotics for treating bacterial vaginosis in pregnancy. The Cochrane Database of Systematic Reviews. 2005;(1):CD000262.

Ness A, Dias T, et al. Impact of the recent randomized trials on the use of progesterone to prevent preterm birth: a 2005 follow-up survey. Am J Obstet Gynecol. 2006;195:1174-1179.

Prematurity. EBSCO DynaMed website. Available at: http://dynamed.ebscohost.com/about/about-us. Updated April 18, 2013 . Accessed April 23, 2013.

Preterm labor. EBSCO DynaMed website. Available at: http://dynamed.ebscohost.com/about/about-us. Updated March 15, 2013 . Accessed April 23, 2013.

Stanley FJ, Crowther C. Antenatal magnesium sulfate for neuroprotection before preterm birth? N Engl J Med. 2008; 359:962-964.

What treatments can reduce the chances of preterm labor & birth? National Institute of Child Health & Human Development website. Available at: http://www.nichd.nih.gov/health/topics/preterm/Pages/default.aspx. Updated November 30, 2013. Accessed April 23, 2013.

Whitworth M, Quenby S; Cochrane Pregnancy and Childbirth Group. Prophylactic oral betamimetics for preventing preterm labour in singleton pregnancies. The Cochrane Database of Systematic Reviews. 2009; (1).

Yemini M, Borenstein R, et al. Prevention of premature labor by 17 alpha-hydroxyprogesterone caproate. Am J Obstet Gynecol. 1985;151:574-577.

Zhu BP, Haines KM, et al. Effect of the interval between pregnancies on perinatal outcomes among white and black women. Am J Obstet Gynecol. 2001;185:1403-1410.

Last reviewed June 2013 by Andrea Chisholm

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


 
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