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Labour-delaying tocolytic drugs may lead to maternal complications

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Delaying early labour has been called into question by a Flemish study revealing the serious adverse reactions of using tocolytic drugs

Tocolytic drugs are used to buy women and their unborn children time – to get them to neonatal intensive care units and for the administration of steroids to speed up premature babies’ lung development.

However, the study assessed the incidence of serious maternal complications in 1,920 women treated with the drugs at 28 hospitals in the Netherlands and Belgium over 18 months.

The most commonly used drug was atosiban (42%), followed by nifedipine (34%), beta agonists (14%), and indometacin (8%).

Whilst overall incidence of adverse effects was only 0.7%, combined treatment led to five serious adverse drug reactions (1.6%). A single treatment with a beta agonist also led to three serious adverse drug reactions (1.7%).

Indometacin and atosiban were the only tocolytic drugs not associated with serious adverse drug reactions.

The authors, writing in the BMJ, concluded that use of multiple treatments or beta agonists should be discouraged.

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