It is inherent to human logic that both doctors and patients want to suppress uterine contractions when a woman presents in threatened preterm labor. Tocolysis is widely applied in women with threatened preterm labor with a variety of drugs. According to literature, tocolysis is indicated to enable transfer to a tertiary center as well as to ensure the administration of corticosteroids for fetal maturation. There is international discrepancy in the content and the implementation of guidelines on preterm labor. Tocolysis is often maintained or repeated. Nevertheless, the benefit of prolonging pregnancy has not yet been proven, and it is not impossible that prolongation of the pregnancy in a potential hostile environment could harm the fetus. Here we reflect on the use of tocolysis, focusing on maintenance and repeated tocolysis, and compare international guidelines and practices to available evidence. Finally, we propose strategies to improve the evaluation and use of tocolytics, with potential implications for future research.
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http://dx.doi.org/10.1053/j.semperi.2017.08.005 | DOI Listing |
J Matern Fetal Neonatal Med
December 2025
Fetal Medicine and Gynecology Department, Medical University of Lodz, Lodz, Poland.
Objective: We aimed to compare the perinatal outcomes in women with cervical dilatation with fetal membranes visible before 26 weeks of gestation managed with an adjunctive pessary after emergency cervical cerclage or emergency cerclage alone.
Methods: We performed a retrospective analysis of women with singleton gestation, diagnosed with cervical dilatation accompanied by fetal membranes visible at or beyond the external os, who underwent emergency cervical cerclage. The participants were recruited at 3 tertiary perinatal centers.
J Obstet Gynaecol Res
March 2025
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Aim: To compare the safety and efficacy of ultrasound- and physical examination-indicated cervical cerclage in twin versus singleton gestations.
Methods: A retrospective cohort study of all ultrasound-indicated (cervical length ≤ 25 mm) and physical examination-indicated cerclage cases performed over a 9-year period. The primary outcome was the time interval from cerclage placement to delivery.
BMC Pregnancy Childbirth
March 2025
Department of Obstetrics and Gynaecology, West China Second University Hospital, Sichuan University, No. 20, Renmin South Road, Section 3, 610041, Chengdu, Chengdu, Sichuan, China.
Background: The high prevalence of caesarean section (CS) is a global concern. Relaparotomy is needed when conservative managements are not effective in CS complications. This study aimed to systematically review and meta-analyze the mortality rate and risk factors of relaparotomy after CS.
View Article and Find Full Text PDFBMC Pregnancy Childbirth
March 2025
Department of Obstetrics and Gynecology, General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, Shenyang, 110016, China.
Background: The association between interpregnancy interval (IPI) after vaginal delivery and preterm birth (PTB) in singleton has not been elucidated. The aim of this study is to investigate the association between interpregnancy interval after vaginal delivery and preterm birth.
Methods: Birth data from the 2022 National Vital Statistics System (NVSS) were selected, and multinomial logistic regression models were used to determine the odds ratios (OR) and 95% confidence intervals (95% CI) for the association between IPI after vaginal delivery and PTB.
BMC Pregnancy Childbirth
March 2025
Department of Obstetrics, Sichuan Provincial Women's and Children's Hospital, The Affiliated Women's and Children's Hospital of Chengdu Medical College, Chengdu, Sichuan, China.
Background: The risk of preterm birth (PTB) is associated with maternal hyperglycemia but differs by combinations of abnormal oral glucose tolerance test (OGTT) values. However, the potential pathway by which maternal hyperglycemia affects PTB is unclear. This study aimed to investigate the association between OGTT-related measures and PTB and evaluate the mediation effect of gestational weight gain (GWG) on the association between maternal hyperglycemia and the risk of PTB in women with gestational diabetes mellitus (GDM).
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