What Doctors Don't Tell YouWomen who experience threatened premature labour are often given maintenance doses of tocolytic drugs (muscle relaxants) in order to prevent a recurrence. But a recent review suggests this may be bad practice.
The meta-analysis of 12 trials involving more than 1,600 women concluded that tocolytics, such as beta-sympathomimetics, do not prevent preterm labour or preterm delivery, and have no impact on the baby’s health. Once a woman recovers from a threatened premature labour, she will not benefit from continuing to take the drug. The authors conclude that there is sufficient evidence to show that routine maintenance treatment with tocolytics should stop (Am J Ob Gyn, 1999; 181; 484-90).
l In a related case study, a baby born to a woman receiving nimesulide, a cyclo-oxygenase-type-1, or COX-1, selective inhibitor, as a tocolytic developed chronic kidney failure. The authors point out that the drug is in fact contraindicated in pregnancy, which begs the question of why it was being used (Lancet, 1999; 354: 1615).
Maryon Stewart
Daniel Redwood DC
Tom Ferguson MD